RICH MOUNTIAN FAMILY MEDICAL CLINIC NPI 1477688554

NPI Information

RICH MOUNTIAN FAMILY MEDICAL CLINIC is a primary care clinic center in Mena, AR. RICH MOUNTIAN FAMILY MEDICAL CLINIC NPI is 1477688554. The provider is registered as an organization entity type.

The provider's business location address is:

209 MORROW ST N
MENA, AR
ZIP 71953-514
Phone: (479) 394-4703
Fax: (479) 394-2126

The provider's authorized official is John Henry Finck .
The authorized official title is Manager and has the following contact phone number (479) 394-4703.

The CLIA number assigned to this NPI record is 04D0466061 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/22/2007 and was last updated on 3/14/2011.

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:

Other Identifiers

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

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