Provider Demographics
NPI:1508162496
Name:NATIONAL PARK FAMILY CARE, LLC
Entity Type:Organization
Organization Name:NATIONAL PARK FAMILY CARE, LLC
Other - Org Name:HOLLYWOOD AVENUE FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:PO BOX 4811
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4811
Mailing Address - Country:US
Mailing Address - Phone:501-624-0070
Mailing Address - Fax:501-624-8721
Practice Address - Street 1:124 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7057
Practice Address - Country:US
Practice Address - Phone:501-624-0070
Practice Address - Fax:501-624-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC1391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty