MEDICARE: WOODLAND HEALTH 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
1	314000000X	Skilled Nursing Facility	790	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	015259	OTHER	AR	MEDIPAK

General Provider Information

NPI Number	:	1518920388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLAND HEALTH LLC

Provider Business Mailing Address
First Line	:	2908 HAWKINS DR
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143
Country	:	US
Telephone Number	:	501-305-3153
Fax Number	:	501-279-3796

Provider Business Practice Location Address
First Line	:	8701 RILEY DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205
Country	:	US
Telephone Number	:	501-224-2700
Fax Number	:	501-907-0629

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEY MARTIN WIGGINS
Credential	:
Telephone Number	:	501-305-3153

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	08/22/2020

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Directions to “WOODLAND HEALTH LLC ” Practice Location

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