MEDICARE: SARC ASC PARAGOULD LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1447075932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARC ASC PARAGOULD LLC

Provider Business Mailing Address
First Line	:	1507 LINWOOD DR
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5818
Country	:	US
Telephone Number	:	870-565-4157
Fax Number	:	870-738-8134

Provider Business Practice Location Address
First Line	:	1507 LINWOOD DR
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5818
Country	:	US
Telephone Number	:	870-565-4157
Fax Number	:	870-738-8134

Authorized Official
Title or Position	:	OWNER
Name	:	SADEEM MAHMOOD
Credential	:	MD
Telephone Number	:	870-565-4157

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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Directions to “SARC ASC PARAGOULD LLC ” Practice Location

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