Provider Demographics
NPI:1932289998
Name:NORTH PULASKI WOMENS CLINIC
Entity Type:Organization
Organization Name:NORTH PULASKI WOMENS CLINIC
Other - Org Name:HORIZONS FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIRMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-992-1910
Mailing Address - Street 1:2402 WILDWOOD AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120
Mailing Address - Country:US
Mailing Address - Phone:501-992-1910
Mailing Address - Fax:501-992-1915
Practice Address - Street 1:2402 WILDWOOD AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120
Practice Address - Country:US
Practice Address - Phone:501-992-1910
Practice Address - Fax:501-992-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR121353002Medicaid
AR121353002Medicaid