Healthcare Provider Details

I. General information

NPI: 1265477582
Provider Name (Legal Business Name): PREMIER CENTRAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S MAIN ST STE 5
HOPE AR
71801-8124
US

IV. Provider business mailing address

PO BOX 1387
HOPE AR
71802-1387
US

V. Phone/Fax

Practice location:
  • Phone: 870-722-6568
  • Fax: 870-722-6353
Mailing address:
  • Phone: 870-722-6568
  • Fax: 870-722-6353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE4344
License Number StateAR

VIII. Authorized Official

Name: DR. SANDRA ANN KAEHUKAI SOOMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 870-722-6568