LAWRENCE MEMORIAL HEALTH FOUNDATION INC. NPI 1528052107

NPI Information

NPI: 1528052107
Provider Name: LAWRENCE MEMORIAL HEALTH FOUNDATION INC.

Doing Business As: FAMILY MEDICAL CENTER

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

Specialization: Rural Health

Address:
1309 W MAIN ST
WALNUT RIDGE, AR
ZIP 72476
Phone: (870) 886-3211
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LAWRENCE MEMORIAL HEALTH FOUNDATION INC. is a rural health clinic center in Walnut Ridge, AR. LAWRENCE MEMORIAL HEALTH FOUNDATION INC. NPI is 1528052107. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Medical Center.

The provider's business location address is:

1309 W MAIN ST
WALNUT RIDGE, AR
ZIP 72476-430
Phone: (870) 886-3211
Fax: (870) 886-9027

The provider's authorized official is Vanessa K Wagner .
The authorized official title is Cfo and has the following contact phone number (870) 886-1263.

The CLIA number assigned to this NPI record is 04D0691080 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2005 and was last updated on 7/21/2020.

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	261QR1300X	Clinic/Center	Rural Health			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	234112729	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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