1477549756 NPI number — UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Table of content: (NPI 1477549756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477549756 NPI number — UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
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:
THE UNIVERSITY HOSPITAL OF ARKANSAS
Provider Other Organization Name Type Code:
3
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:
1477549756
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3920
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72203-3920
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-614-2830
Provider Business Mailing Address Fax Number:
501-666-4936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4301 W MARKHAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205-7101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-614-2830
Provider Business Practice Location Address Fax Number:
501-666-4936
Provider Enumeration Date:
09/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GEORGE
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ASSOC VC FOR CLINICAL FINANCE
Authorized Official Telephone Number:
501-686-5670

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  AR4128 , 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)

  • Identifier: 6130390 . This is a "AETNA" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 106180200 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 10016 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 026311399 . This is a "ENTERGY-DEPT OF LABOR" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 104266105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: HO 0002 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: HS74572 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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