Healthcare Provider Details

I. General information

NPI: 1144352998
Provider Name (Legal Business Name): CITY OF ROGERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N 1ST ST
ROGERS AR
72756-6600
US

IV. Provider business mailing address

201 N 1ST ST
ROGERS AR
72756-6600
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-1179
  • Fax: 479-621-1108
Mailing address:
  • Phone: 479-621-1179
  • Fax: 479-621-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number130
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number130
License Number StateAR

VIII. Authorized Official

Name: MEGAN LEIGH VANATTA
Title or Position: ADMINISTRATION MANAGER
Credential:
Phone: 479-621-1179