| Portland Elementary Clinic | |
|
314 Highway 160 E Portland AR 71663-9262 | |
| (870) 538-5414 | |
| (870) 538-5412 |
| Full Name | Portland Elementary Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 314 Highway 160 E, Portland, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Elementary Clinic Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Portland Elementary Clinic 314 Highway 160 E Portland AR 71663-9262 Ph: (870) 538-5414 |
| NPI Number | 1649636986 |
|---|---|
| Provider Enumeration Date | 12/31/2015 |
| Last Update Date | 07/10/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20160520000551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649636986 | NPI | - | NPPES |
| 214420749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Portland Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 233 N Main St, Portland, AR 71663 Phone: 870-737-2221 Fax: 855-878-5991 |