Provider Demographics
NPI:1740246966
Name:AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Entity type:Organization
Organization Name:AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, VICE PRESIDENT OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SWILLING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:800-737-1827
Mailing Address - Street 1:524 GARRISON AVE
Mailing Address - Street 2:PO BOX 1724
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-2514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:257 AIRPORT ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-9266
Practice Address - Country:US
Practice Address - Phone:479-667-4870
Practice Address - Fax:479-667-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR047158Medicare Oscar/Certification