Healthcare Provider Details
I. General information
NPI: 1780969873
Provider Name (Legal Business Name): WHITE COUNTY URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2011
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2902 E RACE AVE
SEARCY AR
72143-4806
US
IV. Provider business mailing address
PO BOX 848
BEEBE AR
72012-0848
US
V. Phone/Fax
- Phone: 501-882-5433
- Fax: 501-882-2512
- Phone: 501-882-5433
- Fax: 501-882-2512
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DEWEY
R
MCAFEE
Title or Position: PRESIDENT/OWNER
Credential: DO
Phone: 501-230-9115