Healthcare Provider Details

I. General information

NPI: 1568471571
Provider Name (Legal Business Name): ARKANSAS RURAL KARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#4 HWY 71 NE
MOUNTAINBURG AR
72946
US

IV. Provider business mailing address

310 TOWSON AVE
FORT SMITH AR
72901-3831
US

V. Phone/Fax

Practice location:
  • Phone: 479-369-2091
  • Fax: 479-369-4119
Mailing address:
  • Phone: 479-494-0009
  • Fax: 479-494-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WAYNE KING
Title or Position: ADMINISTRATOR
Credential:
Phone: 479-494-0009