Provider Demographics
NPI:1942375639
Name:CONWAY REGIONAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CONWAY REGIONAL MEDICAL CENTER INC
Other - Org Name:GREENBRIER FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-450-2114
Mailing Address - Street 1:110 N BROADVIEW ST
Mailing Address - Street 2:P.O. BOX 476
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-9475
Mailing Address - Country:US
Mailing Address - Phone:501-679-3551
Mailing Address - Fax:501-679-4536
Practice Address - Street 1:110 N BROADVIEW ST
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058-9475
Practice Address - Country:US
Practice Address - Phone:501-679-3551
Practice Address - Fax:501-679-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR043854Medicare ID - Type UnspecifiedRURAL