| Sheridan East End | |
|
5205 W Sawmill Rd Little Rock AR 72206-9063 | |
| (870) 942-7927 | |
| (870) 942-3005 |
| Full Name | Sheridan East End |
|---|---|
| Speciality | Clinic/Center |
| Location | 5205 W Sawmill Rd, Little Rock, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheridan East End Po Box 509 Dermott AR 71638-0509 Ph: (870) 538-5414 | Sheridan East End 5205 W Sawmill Rd Little Rock AR 72206-9063 Ph: (870) 942-7927 |
| NPI Number | 1578283693 |
|---|---|
| Provider Enumeration Date | 08/30/2022 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20230426002603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578283693 | NPI | - | NPPES |
| 301057749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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