Healthcare Provider Details

I. General information

NPI: 1801973904
Provider Name (Legal Business Name): EAST ARKANSAS AREA AGENCY ON AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 E HIGHLAND DR
JONESBORO AR
72401-6123
US

IV. Provider business mailing address

PO BOX 5035
JONESBORO AR
72403-5035
US

V. Phone/Fax

Practice location:
  • Phone: 870-930-2212
  • Fax: 870-930-2230
Mailing address:
  • Phone: 870-930-2212
  • Fax: 870-930-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMMY DARR
Title or Position: ASSISTANT DIRECTOR OF FINANCE
Credential:
Phone: 870-930-2212