Provider Demographics
NPI:1770997231
Name:BAPTIST HEALTH ONSITE EMPLOYEE CLINIC
Entity type:Organization
Organization Name:BAPTIST HEALTH ONSITE EMPLOYEE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OF ARKANSAS HEALTH GROUP
Authorized Official - Prefix:
Authorized Official - First Name:WILLOUGHBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-812-7521
Mailing Address - Street 1:9600 BAPTIST HEALTH DR
Mailing Address - Street 2:STE 260
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6326
Mailing Address - Country:US
Mailing Address - Phone:501-312-8844
Mailing Address - Fax:
Practice Address - Street 1:11001 EXECUTIVE CENTER DR
Practice Address - Street 2:STE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4316
Practice Address - Country:US
Practice Address - Phone:501-812-7521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARKANSAS HEALTH GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care