| |
3202 N 6th St Fort Smith AR 72904-4164 | |
(479) 783-3900 | |
(479) 783-3905 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3202 N 6th St, Fort Smith, Arkansas |
Authorized Official Name and Position | Jerry J. White (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4794312057 |
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 130 Ratcliff AR 72951-0130 Ph: (479) 635-0091 | 3202 N 6th St Fort Smith AR 72904-4164 Ph: (479) 783-3900 |
NPI Number | 1568647519 |
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Provider Enumeration Date | 01/08/2008 |
Last Update Date | 06/08/2020 |
Medicare PECOS PAC ID | 0042274276 |
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Medicare Enrollment ID | O20090311000506 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568647519 | NPI | - | NPPES |
176996749 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Healthmax Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12300 Highway 71 S, Suite A, Fort Smith, AR 72916 Phone: 479-755-6595 Fax: 479-755-6596 | |
Waldron Place Pediatric Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 S Waldron Rd Ste 202, Fort Smith, AR 72903 Phone: 479-452-8311 Fax: 479-452-5032 | |
Remedy Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 S Waldron Rd Ste 100, Fort Smith, AR 72903 Phone: 479-888-8305 Fax: 918-395-9149 | |