| Community Clinic Pea Ridge | |
|
1923 W Pickens Road Pea Ridge AR 72751 | |
| (479) 751-7417 | |
| (479) 751-4898 |
| Full Name | Community Clinic Pea Ridge |
|---|---|
| Speciality | Clinic/Center |
| Location | 1923 W Pickens Road, Pea Ridge, Arkansas |
| Authorized Official Name and Position | James Semingson (CEO) |
| Authorized Official Contact | 4797517417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Clinic Pea Ridge 614 E Emma Ave Ste 300 Springdale AR 72764-4469 Ph: (479) 751-7417 | Community Clinic Pea Ridge 1923 W Pickens Road Pea Ridge AR 72751 Ph: (479) 751-7417 |
| NPI Number | 1669099073 |
|---|---|
| Provider Enumeration Date | 07/01/2020 |
| Last Update Date | 08/04/2020 |
| Medicare PECOS PAC ID | 0042262495 |
|---|---|
| Medicare Enrollment ID | O20200916001627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669099073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Arcare135 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 N Curtis Ave, Pea Ridge, AR 72751 Phone: 479-451-0579 Fax: 479-451-0297 |