MEDICARE: AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1053313916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Provider Business Mailing Address
First Line	:	PO BOX 1724
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72902-1724
Country	:	US
Telephone Number	:	479-783-4500
Fax Number	:	855-515-7414

Provider Business Practice Location Address
First Line	:	3600 WHEELER AVE STE 2
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-6621
Country	:	US
Telephone Number	:	479-783-4500
Fax Number	:	855-515-7414

Authorized Official
Title or Position	:	CFO
Name	:	DANA CALLAWAY
Credential	:
Telephone Number	:	479-424-2020

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/07/2025

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