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General NPI Number Information
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NPI Number | 1639093149
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Entity Type | Organization
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Legal Business Name | MGA HEALTHCARE ARKANSAS LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 3291 S THOMPSON ST STE E104
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City | SPRINGDALE
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State | AR
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Zip | 72764-7096
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Country | US
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Telephone | 479-304-6534
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Fax | 479-546-2275
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Provider Business Mailing Address
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Address Line | 7025 N SCOTTSDALE RD STE 200
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-3675
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Country | US
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Telephone | 479-304-6534
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Fax | 479-546-2275
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | ALEXANDRA KOLOSKUS
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Credential |
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Telephone | 720-276-7706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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