Full Name | |
---|---|
Speciality | Clinic/center |
Location | 169 North 2 Ave, Hartford, Arkansas |
Authorized Official Name and Position | Bobby D Pugh (OWNER) |
Authorized Official Contact | 3347148384 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
P O Box 1104 Slocomb AL 36375-1104 Ph: (334) 886-7050 | 169 North 2 Ave Hartford AR 36344 Ph: (334) 714-8384 |
NPI Number | 1114252814 |
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Provider Enumeration Date | 10/14/2009 |
Last Update Date | 10/14/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114252814 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Alabama) | Primary |