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General NPI Number Information
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NPI Number | 1780105015
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Entity Type | Organization
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Legal Business Name | CSS HEALTHCARE, LLC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 525 W FAULKNER ST
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City | EL DORADO
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State | AR
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Zip | 71730-4518
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Country | US
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Telephone | 870-639-3910
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Fax | 870-639-3913
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Provider Business Mailing Address
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Address Line | PO BOX 1384
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City | EL DORADO
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State | AR
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Zip | 71731-1384
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Country | US
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Telephone | 870-639-3910
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Fax | 870-639-3913
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MELISSA LANGSTON
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Credential |
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Telephone | 870-639-3910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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