| Lee County Cooperative Clinic | |
|
14264 Highway 44 Wabash AR 72389 | |
| (870) 295-5225 | |
| (870) 295-6900 |
| Full Name | Lee County Cooperative Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 14264 Highway 44, Wabash, Arkansas |
| Authorized Official Name and Position | Ossie M Hall (CASHIER/BILLING SUPERVISOR) |
| Authorized Official Contact | 8702955225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee County Cooperative Clinic Po Box 669 Marianna AR 72360-0669 Ph: (870) 295-5225 | Lee County Cooperative Clinic 14264 Highway 44 Wabash AR 72389 Ph: (870) 295-5225 |
| NPI Number | 1356359442 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 03/02/2021 |
| Medicare PECOS PAC ID | 8921917204 |
|---|---|
| Medicare Enrollment ID | O20100818001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356359442 | NPI | - | NPPES |
| 125274749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |