| Rvpcs - Eastside Family Clinic | |
|
4003 Massard Rd Fort Smith AR 72903-6221 | |
| (479) 434-4747 | |
| (479) 434-4949 |
| Full Name | Rvpcs - Eastside Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4003 Massard Rd, Fort Smith, Arkansas |
| Authorized Official Name and Position | Jerome J White (EX. DIRECTOR) |
| Authorized Official Contact | 4794312057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rvpcs - Eastside Family Clinic Po Box 130 Ratcliff AR 72951-0130 Ph: (479) 635-5300 | Rvpcs - Eastside Family Clinic 4003 Massard Rd Fort Smith AR 72903-6221 Ph: (479) 434-4747 |
| NPI Number | 1619232295 |
|---|---|
| Provider Enumeration Date | 07/10/2012 |
| Last Update Date | 08/16/2021 |
| Medicare PECOS PAC ID | 0042274276 |
|---|---|
| Medicare Enrollment ID | O20121119000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619232295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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