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1341 W 6th St Waldron AR 72958-7642 | |
(479) 637-2136 | |
(479) 637-5411 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1341 W 6th St, Waldron, Arkansas |
Authorized Official Name and Position | Sherry Lynn Clouse Day (VP FINANCE MERCY CAH) |
Authorized Official Contact | 4178208439 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5401 Ellsworth Rd Fort Smith AR 72903-3219 Ph: (479) 314-1101 | 1341 W 6th St Waldron AR 72958-7642 Ph: (479) 637-2136 |
NPI Number | 1043268451 |
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Provider Enumeration Date | 05/05/2006 |
Last Update Date | 02/17/2021 |
Medicare PECOS PAC ID | 5597658005 |
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Medicare Enrollment ID | O20040426001879 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043268451 | NPI | - | NPPES |
100698850C | Medicaid | OK | |
5B332 | Other | AR | BLUECROSS BLUESHIELD |
146846729 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |