Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1018 Us 49, Marvell, Arkansas |
Authorized Official Name and Position | Susan Ward-jones (CEO) |
Authorized Official Contact | 8707353842 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
900 N 7th St West Memphis AR 72301-2001 Ph: (870) 735-3842 | 1018 Us 49 Marvell AR 72366 Ph: (870) 829-1194 |
NPI Number | 1215436613 |
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Provider Enumeration Date | 02/12/2018 |
Last Update Date | 11/18/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215436613 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |