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CONWAY REGIONAL MEDICAL CENTER INC NPI 1265421861


NPI Information

NPI: 1265421861
Provider Name: CONWAY REGIONAL MEDICAL CENTER, INC

Doing Business As: CLINTON MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 04D0466223

Address:
2526 HIGHWAY 65 S
SUITE 203
CLINTON, AR
ZIP 72031
Phone: (501) 745-4914
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CONWAY REGIONAL MEDICAL CENTER, INC is a rural health clinic center in Clinton, AR. CONWAY REGIONAL MEDICAL CENTER, INC NPI is 1265421861. The provider is registered as an organization entity type.
The provider Is Doing Business As Clinton Medical Clinic.

The provider's business location address is:

2526 HIGHWAY 65 S
SUITE 203
CLINTON, AR
ZIP 72031-657
Phone: (501) 745-4914
Fax: (501) 745-6374

The provider's authorized official is William Pack .
The authorized official title is Cfo and has the following contact phone number (501) 450-2112.

The CLIA number assigned to this NPI record is 04D0466223 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/17/2005 and was last updated on 11/9/2023.


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
1261QR1300XClinic/CenterRural HealthYes

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
1126874002MEDICAIDARKANSAS
2128440729MEDICAIDARKANSAS

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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