Provider Demographics
NPI:1740905553
Name:AFFINITY PALLIATIVE CARE OF ARKANSAS
Entity type:Organization
Organization Name:AFFINITY PALLIATIVE CARE OF ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-949-0400
Mailing Address - Street 1:135 GEMINI CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5842
Mailing Address - Country:US
Mailing Address - Phone:205-949-0400
Mailing Address - Fax:870-534-4884
Practice Address - Street 1:201 FRANKIE LN
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-2683
Practice Address - Country:US
Practice Address - Phone:870-534-4847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFINITY HOSPICE OF ARKANSAS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-05
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty