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606 Highway 365 Mayflower AR 72106-9595 | |
(501) 470-7413 | |
(501) 470-7415 |
Full Name | |
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Speciality | Clinic/Center |
Location | 606 Highway 365, Mayflower, Arkansas |
Authorized Official Name and Position | William Pack (CFO) |
Authorized Official Contact | 5014502112 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 9662 Conway AR 72033-9662 Ph: (501) 852-1363 | 606 Highway 365 Mayflower AR 72106-9595 Ph: (501) 470-7413 |
NPI Number | 1851389605 |
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Provider Enumeration Date | 10/06/2005 |
Last Update Date | 11/09/2023 |
Medicare PECOS PAC ID | 3173428414 |
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Medicare Enrollment ID | O20230327001163 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851389605 | NPI | - | NPPES |
127018002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mayflower Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 587 Highway 365, Mayflower, AR 72106 Phone: 501-470-7413 Fax: 501-470-7415 |