| Och Benton County Clinic | |
|
102 Russell Road Rogers AR 72756 | |
| (479) 278-7189 | |
| (479) 278-2199 |
| Full Name | Och Benton County Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 Russell Road, Rogers, Arkansas |
| Authorized Official Name and Position | Paul G Taylor (CEO) |
| Authorized Official Contact | 4178374004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Och Benton County Clinic 102 Russell Road Rogers AR 72756 | Och Benton County Clinic 102 Russell Road Rogers AR 72756 Ph: (479) 278-7189 |
| NPI Number | 1154945483 |
|---|---|
| Provider Enumeration Date | 06/02/2020 |
| Last Update Date | 06/12/2020 |
| Certification Date | 06/12/2020 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20200617003148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154945483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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