Provider Demographics
NPI:1053313916
Name:AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Entity type:Organization
Organization Name:AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-424-2020
Mailing Address - Street 1:PO BOX 1724
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72902-1724
Mailing Address - Country:US
Mailing Address - Phone:479-783-4500
Mailing Address - Fax:855-515-7414
Practice Address - Street 1:3600 WHEELER AVE STE 2
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-6621
Practice Address - Country:US
Practice Address - Phone:479-783-4500
Practice Address - Fax:855-515-7414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR047034Medicare Oscar/Certification