=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033589890
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARDENT BILLING & CONSULTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2015
-----------------------------------------------------
Last Update Date | 10/05/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 WILDWOOD AVE UNIT 6421
-----------------------------------------------------
City | SHERWOOD
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72124-7600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-503-2222
-----------------------------------------------------
Fax | 501-503-2220
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2300 WILDWOOD AVE UNIT 6421
-----------------------------------------------------
City | SHERWOOD
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72124-7600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-503-2222
-----------------------------------------------------
Fax | 501-503-2220
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER MANAGER
-----------------------------------------------------
Name | MRS. ERIN K PATTERSON
-----------------------------------------------------
Credential | RDA
-----------------------------------------------------
Telephone | 501-503-2222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171W00000X
-----------------------------------------------------
Taxonomy Name | Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------