BOSTON MOUNTAIN RURAL HEALTH CENTER INC NPI 1376631846

NPI Information

NPI: 1376631846
Provider Name: BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 04D0887822

Address:
465 MEDICAL CENTER PARKWAY
CLINTON, AR
ZIP 72031
Phone: (501) 745-7888
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BOSTON MOUNTAIN RURAL HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Clinton, AR. BOSTON MOUNTAIN RURAL HEALTH CENTER, INC NPI is 1376631846. The provider is registered as an organization entity type.

The provider's business location address is:

465 MEDICAL CENTER PARKWAY
CLINTON, AR
ZIP 72031
Phone: (501) 745-7888

The provider's authorized official is Debbie Ackerson .
The authorized official title is Ceo and has the following contact phone number (870) 448-5733.

The CLIA number assigned to this NPI record is 04D0887822 - federally qualified health center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 1/28/2019.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	DA1111	OTHER	ARKANSAS	RAILROAD GROUP ID MEDICAR
2	5B477	OTHER	ARKANSAS	BLUE CROSS OF ARKANSAS
3	133965749	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: 4/28/2024

NPI Synchronization or Removal

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