1356856660 NPI number — PRECISION HEALTHCARE, INC. ARKANSAS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356856660 NPI number — PRECISION HEALTHCARE, INC. ARKANSAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRECISION HEALTHCARE, INC. ARKANSAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356856660
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 CENTERVIEW DR STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-3248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-367-1444
Provider Business Mailing Address Fax Number:
888-615-1445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 A PARKWOOD STREET
Provider Second Line Business Practice Location Address:
PARKWOOD SUITES TWO
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72745-8811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-361-8601
Provider Business Practice Location Address Fax Number:
888-615-1445
Provider Enumeration Date:
12/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SEIBELS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-610-3727

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com