Healthcare Provider Details

I. General information

NPI: 1013522127
Provider Name (Legal Business Name): SARC BY HSH ASC PINE BLUFF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 S HAZEL ST
PINE BLUFF AR
71603-7836
US

IV. Provider business mailing address

7200 S HAZEL ST
PINE BLUFF AR
71603-7836
US

V. Phone/Fax

Practice location:
  • Phone: 870-939-6380
  • Fax: 870-534-9726
Mailing address:
  • Phone: 870-939-6380
  • Fax: 870-534-9726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUHAMMAD MUNSIF BUTT
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 501-777-2283