1710465190 NPI number — ARCARE

Table of content: (NPI 1710465190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710465190 NPI number — ARCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCARE
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:
6
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:
1710465190
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
117 S 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72006-2309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-347-2508
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3150 E. HERITAGE PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-400-1140
Provider Business Practice Location Address Fax Number:
479-400-1151
Provider Enumeration Date:
07/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
COLLIER
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
870-347-3300

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 251258749 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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