Organization Name: | ARKANSAS STAFF ASSISTED HEMODIALYSIS,INC |
NPI Number: | 1386053296 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BALBEER K GODWIN (CLINICAL ADMINISTRATOR) |
Mailing Address: | 321 Terry Pond Cv White Hall |
State: | AR US |
Postal Code: | 716028212 |
Phone Number: | 2817997089 |
Fax Number: | 7134001930 |
NPI Enumeration Date: | 08/05/2014 |
NPI Last Update Date: | 08/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |