Provider Demographics
NPI:1801504592
Name:PATHWAY HEALTHCARE ARKANSAS LLC
Entity type:Organization
Organization Name:PATHWAY HEALTHCARE ARKANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-208-9312
Mailing Address - Street 1:1000 URBAN CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2584
Mailing Address - Country:US
Mailing Address - Phone:205-208-9312
Mailing Address - Fax:205-848-2227
Practice Address - Street 1:240 S MAIN STREET
Practice Address - Street 2:SUITE 726
Practice Address - City:BENTONVILLE
Practice Address - State:AZ
Practice Address - Zip Code:72712
Practice Address - Country:US
Practice Address - Phone:205-208-9312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty