Provider Demographics
NPI:1033997275
Name:EAST ARKANSAS FAMILY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:EAST ARKANSAS FAMILY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WARD-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-733-6388
Mailing Address - Street 1:900 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2001
Mailing Address - Country:US
Mailing Address - Phone:870-735-3842
Mailing Address - Fax:
Practice Address - Street 1:301 W POLK AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4262
Practice Address - Country:US
Practice Address - Phone:870-735-3842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST ARKANSAS FAMILY HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)