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NPI Code Detail

MEDICARE: CROSSETT HEALTH FOUNDATION

MEDICARE: CROSSETT HEALTH FOUNDATION
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
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1578567111
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSETT HEALTH FOUNDATION
Provider Business Mailing Address
First Line : PO BOX H
Second Line :
City : CROSSETT
State : AR
Zip : 71635-1808
Country : US
Telephone Number : 870-364-9519
Fax Number : 870-304-2156
Provider Business Practice Location Address
First Line : 1003 FRED LAGRONE DR
Second Line :
City : CROSSETT
State : AR
Zip : 71635-4546
Country : US
Telephone Number : 870-364-9519
Fax Number : 870-304-2156
Authorized Official
Title or Position : SENIOR BILLER
Name : ANN MILES
Credential :
Telephone Number : 870-364-9519
Provider Enumeration Date : 06/10/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
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71635-4546
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Practice Fax:
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1861484008 — WILLIAM C. GO JR. MD,PA
Practice Location Address:
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CROSSETT, AR
71635-4546
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Practice Location Address:
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1508842832 — IRA J MURPHY MD
Practice Location Address:
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Directions to “CROSSETT HEALTH FOUNDATION ” Practice Location

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