Provider Demographics
NPI:1245690221
Name:ARKANSAS ELDERCARE, INC.
Entity type:Organization
Organization Name:ARKANSAS ELDERCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-625-3133
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71902-0670
Mailing Address - Country:US
Mailing Address - Phone:501-625-3133
Mailing Address - Fax:
Practice Address - Street 1:26629 HWY. 5
Practice Address - Street 2:
Practice Address - City:LONSDALE
Practice Address - State:AR
Practice Address - Zip Code:72087
Practice Address - Country:US
Practice Address - Phone:501-625-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care