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General NPI Number Information
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NPI Number | 1962161901
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Entity Type | Organization
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Legal Business Name | ARKANSAS CHILDRENS NORTHWEST, INC.
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 2601 GENE GEORGE BLVD
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City | SPRINGDALE
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State | AR
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Zip | 72762-0845
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Country | US
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Telephone | 501-364-2526
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Fax | 501-364-2438
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Provider Business Mailing Address
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Address Line | PO BOX 959794
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9794
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Country | US
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Telephone | 501-364-2526
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Fax | 501-364-2438
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Authorized Official
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Title or Position | A/R CONTROL MANAGER
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Name | SHERYL PHILLIPS
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Credential |
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Telephone | 501-364-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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