Provider Demographics
NPI:1902157589
Name:ARKANSAS DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:ARKANSAS DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL PATIENT CARE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:SPEARS
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:RNP
Authorized Official - Phone:501-661-2757
Mailing Address - Street 1:4815 WEST MARKHAM STREET
Mailing Address - Street 2:SLOT 2
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72250-3867
Mailing Address - Country:US
Mailing Address - Phone:501-661-2757
Mailing Address - Fax:501-661-2855
Practice Address - Street 1:4815 W MARKHAM ST
Practice Address - Street 2:SLOT 2
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3866
Practice Address - Country:US
Practice Address - Phone:501-661-2757
Practice Address - Fax:501-661-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP00857251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare