Brunson Elementary School | |
212 Scoby Dr Warren AR 71671-2050 | |
(870) 226-6754 | |
Not Available |
Full Name | Brunson Elementary School |
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Speciality | Clinic/Center |
Location | 212 Scoby Dr, Warren, 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 |
---|---|
Brunson Elementary School Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Brunson Elementary School 212 Scoby Dr Warren AR 71671-2050 Ph: (870) 226-6754 |
NPI Number | 1578282372 |
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Provider Enumeration Date | 08/24/2022 |
Last Update Date | 07/11/2024 |
Medicare PECOS PAC ID | 5193785590 |
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Medicare Enrollment ID | O20230321000352 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578282372 | NPI | - | NPPES |
299513749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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