1841557725 NPI number — UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

Table of content: (NPI 1841557725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841557725 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:
UAMS FAMILY MEDICAL CLINIC-MAGNOLIA
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:
1841557725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4301 WEST MARKHAM STREET., SLOT# 599
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:
72205-7199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-686-5264
Provider Business Mailing Address Fax Number:
501-686-8506

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 E COLUMBIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAGNOLIA
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71753-2436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-862-2489
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GOODHAND
Authorized Official First Name:
MELONY
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE CHANCELLOR FOR FINANCE AND CFO
Authorized Official Telephone Number:
501-686-5671

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , 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)





Copyright © 2007-2024 www.npivalidator.com