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NPI Code Detail

MEDICARE: PATHFINDER, INC.

MEDICARE: PATHFINDER, INC.
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629035043
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHFINDER, INC.
Provider Business Mailing Address
First Line : PO BOX 647
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72078-0647
Country : US
Telephone Number : 501-982-0528
Fax Number : 501-985-1462
Provider Business Practice Location Address
First Line : 2411 W MAIN ST
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-4211
Country : US
Telephone Number : 501-982-0528
Fax Number : 501-985-1462
Authorized Official
Title or Position : DIRECTOR
Name : MR. JAMES C GREEN
Credential :
Telephone Number : 501-982-0528
Provider Enumeration Date : 04/28/2006
Last Update Date : 11/12/2020

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Directions to “PATHFINDER, INC. ” Practice Location

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