CONWAY ENDOSCOPY CENTER INC. NPI 1265439632

NPI Information

NPI: 1265439632
Provider Name: CONWAY ENDOSCOPY CENTER, INC.
Classification: Clinic/Center - 261QE0800X
Entity Type: Organization

Specialization: Endoscopy

CLIA Number: 04D0919707

Address:
455 HOGAN LN
CONWAY, AR
ZIP 72034
Phone: (501) 764-1960
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CONWAY ENDOSCOPY CENTER, INC. is an endoscopy clinic center in Conway, AR. CONWAY ENDOSCOPY CENTER, INC. NPI is 1265439632. The provider is registered as an organization entity type.

The provider's business location address is:

455 HOGAN LN
CONWAY, AR
ZIP 72034-201
Phone: (501) 764-1960
Fax: (501) 513-0798

The provider's authorized official is Kevin D Heath .
The authorized official title is President and has the following contact phone number (501) 764-1960.

The CLIA number assigned to this NPI record is 04D0919707 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 8/1/2012.

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	261QE0800X	Clinic/Center	Endoscopy	AR3956	ARKANSAS	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
1	11049	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS
2	490005155	MEDICARE PIN	ARKANSAS
3	145383128	MEDICAID	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: 11/14/2023

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