MEDICARE: ELANGWE ENTERPRISES 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
1	207LH0002X	Hospice and Palliative Medicine (Anesthesiology) Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1356662878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELANGWE ENTERPRISES INC

Provider Business Mailing Address
First Line	:	2420 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-4164
Country	:	US
Telephone Number	:	479-782-0244
Fax Number	:	479-226-3148

Provider Business Practice Location Address
First Line	:	2420 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-4164
Country	:	US
Telephone Number	:	479-782-0244
Fax Number	:	479-226-3148

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SUZANNE ELIZABETH WARD
Credential	:
Telephone Number	:	479-782-0244

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	03/11/2024

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Directions to “ELANGWE ENTERPRISES INC ” Practice Location

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