Provider Demographics
NPI:1861424459
Name:SOUTHWEST EMERGENCY ASSOCIATES
Entity type:Organization
Organization Name:SOUTHWEST EMERGENCY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-455-7100
Mailing Address - Street 1:11401 INTERSTATE 30
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7042
Mailing Address - Country:US
Mailing Address - Phone:501-455-7100
Mailing Address - Fax:
Practice Address - Street 1:2909 MILITARY RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-2721
Practice Address - Country:US
Practice Address - Phone:501-315-6500
Practice Address - Fax:501-315-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C091OtherBCBS
AR5C091OtherBCBS