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NPI Code Detail

MEDICARE: HOPE MEDICAL CLINIC INC

MEDICARE: HOPE MEDICAL CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013245471
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE MEDICAL CLINIC INC
Provider Business Mailing Address
First Line : 145 SHAKE RAG RD
Second Line :
City : CLINTON
State : AR
Zip : 72031-6682
Country : US
Telephone Number : 501-745-7161
Fax Number : 501-745-8714
Provider Business Practice Location Address
First Line : 145 SHAKE RAG RD
Second Line :
City : CLINTON
State : AR
Zip : 72031-6682
Country : US
Telephone Number : 501-745-7161
Fax Number : 501-745-8714
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. STEFANIE SHAVER
Credential :
Telephone Number : 501-745-7161
Provider Enumeration Date : 11/24/2009
Last Update Date : 09/22/2014

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Directions to “HOPE MEDICAL CLINIC INC ” Practice Location

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