Provider Demographics
NPI:1366831448
Name:FAMILY FIRST PRIMARY CARE, PA
Entity Type:Organization
Organization Name:FAMILY FIRST PRIMARY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAINEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-679-3998
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-0177
Mailing Address - Country:US
Mailing Address - Phone:501-679-3998
Mailing Address - Fax:
Practice Address - Street 1:25 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058
Practice Address - Country:US
Practice Address - Phone:501-679-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty