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General NPI Number Information
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NPI Number | 1356662878
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Entity Type | Organization
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Legal Business Name | ELANGWE ENTERPRISES INC
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 2420 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-4164
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Country | US
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Telephone | 479-782-0244
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Fax | 479-226-3148
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Provider Business Mailing Address
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Address Line | 2420 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-4164
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Country | US
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Telephone | 479-782-0244
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Fax | 479-226-3148
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SUZANNE ELIZABETH WARD
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Credential |
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Telephone | 479-782-0244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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