Healthcare Provider Details

I. General information

NPI: 1548177520
Provider Name (Legal Business Name): CAROLINE BUCKLEY MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W. BROADWAY ST
NORTH LITTLE ROCK AR
72114
US

IV. Provider business mailing address

201 W. BROADWAY ST
NORTH LITTLE ROCK AR
72114
US

V. Phone/Fax

Practice location:
  • Phone: 642-365-2414
  • Fax: 642-365-2414
Mailing address:
  • Phone: 642-365-2414
  • Fax: 642-365-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHERIE LAVETTE BUCKLEY
Title or Position: MANAGER
Credential:
Phone: 642-365-2414