1356856660 NPI number — PRECISION HEALTHCARE, INC. ARKANSAS

Table of content: (NPI 1356856660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356856660 NPI number — PRECISION HEALTHCARE, INC. ARKANSAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRECISION HEALTHCARE, INC. ARKANSAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356856660
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 CENTERVIEW DR STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-3248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-367-1444
Provider Business Mailing Address Fax Number:
888-615-1445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 A PARKWOOD STREET
Provider Second Line Business Practice Location Address:
PARKWOOD SUITES TWO
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72745-8811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-361-8601
Provider Business Practice Location Address Fax Number:
888-615-1445
Provider Enumeration Date:
12/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SEIBELS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-610-3727

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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