| Boston Mountain Rural Health Center, Inc | |
|
465 Medical Center Parkway Clinton AR 72031 | |
| (501) 745-7888 | |
| Not Available |
| Full Name | Boston Mountain Rural Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 465 Medical Center Parkway, Clinton, Arkansas |
| Authorized Official Name and Position | Debbie Ackerson (CEO) |
| Authorized Official Contact | 8704485733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Mountain Rural Health Center, Inc Po Box 1060 400 Highway 27 South Marshall AR 72650-1060 Ph: (870) 448-5733 | Boston Mountain Rural Health Center, Inc 465 Medical Center Parkway Clinton AR 72031 Ph: (501) 745-7888 |
| NPI Number | 1376631846 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 01/28/2019 |
| Medicare PECOS PAC ID | 3870401722 |
|---|---|
| Medicare Enrollment ID | O20081111000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376631846 | NPI | - | NPPES |
| 5B477 | Other | AR | BLUE CROSS OF ARKANSAS |
| 133965749 | Medicaid | AR | |
| DA1111 | Other | AR | RAILROAD GROUP ID MEDICAR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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