T W WAGNER INC NPI 1548244171

NPI Information

NPI: 1548244171
Provider Name: T W WAGNER INC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
3644 W STATE HIGHWAY 18
MANILA, AR
ZIP 72442
Phone: (870) 561-3300
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T W WAGNER INC is a rural health clinic center in Manila, AR. T W WAGNER INC NPI is 1548244171. The provider is registered as an organization entity type.

The provider's business location address is:

3644 W STATE HIGHWAY 18
MANILA, AR
ZIP 72442-049
Phone: (870) 561-3300
Fax: (870) 561-3307

The provider's authorized official is Tommy W Wagner .
The authorized official title is Owner and has the following contact phone number (870) 561-3300.

The enumeration date for this NPI number is 12/6/2005 and was last updated on 7/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	157742729	MEDICAID	ARKANSAS
2	043856	MEDICARE OSCAR/CERTIFICATION	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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