| Red River Health, Llc | |
|
2908 S Caraway Rd Ste A Jonesboro AR 72401-7345 | |
| (870) 336-2195 | |
| (870) 336-2197 |
| Full Name | Red River Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2908 S Caraway Rd Ste A, Jonesboro, Arkansas |
| Authorized Official Name and Position | Robin Brule (CFO) |
| Authorized Official Contact | 9037927435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red River Health, Llc 1550 Moores Ln Texarkana TX 75503-4657 Ph: (903) 792-7435 | Red River Health, Llc 2908 S Caraway Rd Ste A Jonesboro AR 72401-7345 Ph: (870) 336-2195 |
| NPI Number | 1346923273 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 7416320783 |
|---|---|
| Medicare Enrollment ID | O20230926004033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346923273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Bryan D Bowen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770578072 PECOS PAC ID: 6305749649 Enrollment ID: I20040202000651 |
| Provider Name | Tara Lamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952866626 PECOS PAC ID: 3870929979 Enrollment ID: I20231004003848 |
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