| Community Service Inc. | |
|
100 S Cherokee St. Morrilton AR 72110 | |
| (501) 354-4589 | |
| (501) 354-5410 |
| Full Name | Community Service Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 100 S Cherokee St., Morrilton, Arkansas |
| Authorized Official Name and Position | Angela Lynn Wheat (PA/CREDENTIALING CLERK) |
| Authorized Official Contact | 5013544589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Service Inc. Po Box 679 Morrilton AR 72110 Ph: (501) 354-4589 | Community Service Inc. 100 S Cherokee St. Morrilton AR 72110 Ph: (501) 354-4589 |
| NPI Number | 1770631467 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 03/03/2021 |
| Certification Date | 03/03/2021 |
| Medicare PECOS PAC ID | 3678921681 |
|---|---|
| Medicare Enrollment ID | O20231201001720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770631467 | NPI | - | NPPES |
| 142653726 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10085 (Arkansas) | Primary |
| Provider Name | Wesley C Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548226632 PECOS PAC ID: 1658363882 Enrollment ID: I20040330001471 |
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