Healthcare Provider Details

I. General information

NPI: 1740108943
Provider Name (Legal Business Name): CORECIRCUIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SOUTH ST STE 100
MOUNTAIN HOME AR
72653-4452
US

IV. Provider business mailing address

701 SOUTH ST STE 100
MOUNTAIN HOME AR
72653-4452
US

V. Phone/Fax

Practice location:
  • Phone: 870-987-1024
  • Fax:
Mailing address:
  • Phone: 870-987-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONNA JOHNSON
Title or Position: OWNER
Credential:
Phone: 870-987-1024