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BALD KNOB HEALTHCARE CENTER PA NPI 1003877036


NPI Information

NPI: 1003877036
Provider Name: BALD KNOB HEALTHCARE CENTER, PA
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
2104 HIGHWAY 367 N
BALD KNOB, AR
ZIP 72010
Phone: (501) 724-3110
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BALD KNOB HEALTHCARE CENTER, PA is a clinic center in Bald Knob, AR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BALD KNOB HEALTHCARE CENTER, PA NPI is 1003877036. The provider is registered as an organization entity type.

The provider's business location address is:

2104 HIGHWAY 367 N
BALD KNOB, AR
ZIP 72010-443
Phone: (501) 724-3110
Fax: (501) 724-0140

The provider's authorized official is Tina Renee Holder .
The authorized official title is Medical Office Assistant and has the following contact phone number (501) 724-3110.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 11/3/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterE2849ARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10100548OTHERARKANSASUNITED HEATLHCARE
202080000800OTHERARKANSASQUALCHOICE
35C933OTHERARKANSASBLUE CROSS
4H35824MEDICARE UPINARKANSAS
55C933MEDICARE ID-TYPE UNSPECIFIEDARKANSAS
6152204002MEDICAIDARKANSAS

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: 4/28/2024

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