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NPI Code Detail

MEDICARE: ENDOSCOPY CENTER OF ARKANSAS, LLC

MEDICARE: ENDOSCOPY CENTER OF ARKANSAS, LLC
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
1261QA1903XAmbulatory Surgical Clinic/CenterAR4262AR

General Provider Information

NPI Number : 1063470730
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENDOSCOPY CENTER OF ARKANSAS, LLC
Provider Business Mailing Address
First Line : 1024 N UNIVERSITY AVE
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-6347
Country : US
Telephone Number : 501-537-0900
Fax Number : 501-537-0901
Provider Business Practice Location Address
First Line : 1024 N UNIVERSITY AVE
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72207-6347
Country : US
Telephone Number : 501-537-0900
Fax Number : 501-537-0901
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. PAMELA J HOOPER
Credential : RN
Telephone Number : 501-537-0900
Provider Enumeration Date : 05/03/2006
Last Update Date : 08/22/2020

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Directions to “ENDOSCOPY CENTER OF ARKANSAS, LLC ” Practice Location

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