Healthcare Provider Details

I. General information

NPI: 1295952182
Provider Name (Legal Business Name): EAST ARKANSAS FAMILY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W BROAD
LEPANTO AR
72354
US

IV. Provider business mailing address

102 W BROAD
LEPANTO AR
72354
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-3846
  • Fax: 870-732-1940
Mailing address:
  • Phone: 870-735-3846
  • Fax: 870-732-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN E WARD-JONES
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: MD
Phone: 870-735-3842