Provider Demographics
NPI:1275182677
Name:CENTRAL ARKANSAS SCREENING AND MEDICAL SERVICES
Entity Type:Organization
Organization Name:CENTRAL ARKANSAS SCREENING AND MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:CHERIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RUSSENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:501-424-3016
Mailing Address - Street 1:801 W. LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023
Mailing Address - Country:US
Mailing Address - Phone:501-424-3016
Mailing Address - Fax:501-843-4785
Practice Address - Street 1:801 W. LOCUST ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023
Practice Address - Country:US
Practice Address - Phone:501-424-3016
Practice Address - Fax:501-843-4785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty