Healthcare Provider Details

I. General information

NPI: 1801101902
Provider Name (Legal Business Name): CAREPARTNERS OF NORTHEAST ARKANSAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 COUNTY ROAD 375
BONO AR
72416-7661
US

IV. Provider business mailing address

PO BOX 564
BONO AR
72416-0564
US

V. Phone/Fax

Practice location:
  • Phone: 870-378-3206
  • Fax:
Mailing address:
  • Phone: 870-378-3206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberR52720
License Number StateAR

VIII. Authorized Official

Name: MRS. CATHY ANNETTE HAWKINS
Title or Position: DIRECTOR
Credential: RN
Phone: 870-378-3206