| Montgomery County Community Clinic | |
|
534 Luzerne St Mount Ida AR 71957-9449 | |
| (870) 867-4244 | |
| (870) 867-4254 |
| Full Name | Montgomery County Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 534 Luzerne St, Mount Ida, Arkansas |
| Authorized Official Name and Position | Anthony Calandro (CEO) |
| Authorized Official Contact | 4794373449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery County Community Clinic Po Box 1848 Mena AR 71953-1841 Ph: (479) 437-3449 | Montgomery County Community Clinic 534 Luzerne St Mount Ida AR 71957-9449 Ph: (870) 867-4244 |
| NPI Number | 1265627616 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 01/19/2020 |
| Medicare PECOS PAC ID | 9931018421 |
|---|---|
| Medicare Enrollment ID | O20080317000662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265627616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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