MEDICARE: CATAR LTD

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	261QM2800X	Methadone Clinic	00010	AR

General Provider Information

NPI Number	:	1225213234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATAR LTD

Provider Business Mailing Address
First Line	:	1401 S UNIVERSITY AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-2605
Country	:	US
Telephone Number	:	501-664-7833
Fax Number	:	501-666-2366

Provider Business Practice Location Address
First Line	:	1401 S UNIVERSITY AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-2605
Country	:	US
Telephone Number	:	501-664-7833
Fax Number	:	501-666-2366

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MIGUEL A CASILLAS
Credential	:	M.D.
Telephone Number	:	501-664-7833

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	01/09/2008

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