MEDICARE: CENTRAL AR SPEECH & HEARING

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	261QH0700X	Hearing and Speech Clinic/Center	A#287	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053544502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL AR SPEECH & HEARING

Provider Business Mailing Address
First Line	:	PO BOX 4906
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72214-4906
Country	:	US
Telephone Number	:	601-212-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	6909 GEYER SPRINGS RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-2727
Country	:	US
Telephone Number	:	601-212-4266
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS G ROSS
Credential	:	AUD
Telephone Number	:	601-212-4266

Provider Enumeration Date	:	09/01/2009
Last Update Date	:	09/01/2009

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