Provider Demographics
NPI:1598751562
Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type:Organization
Organization Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Other - Org Name:UAMS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOC VC FOR CLINICAL FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-686-5670
Mailing Address - Street 1:4301 W MARKHAM ST
Mailing Address - Street 2:SLOT 547-10
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-5530
Mailing Address - Fax:501-686-5055
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT 547-10
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-5530
Practice Address - Fax:501-686-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR04246333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100437407Medicaid
AR04-04246OtherNATL ASSOC OF BOARDS RX
AR100437407Medicaid
AR0637640001Medicare NSC