Provider Demographics
NPI:1982716395
Name:LAWRENCE HEALTH SERVICE
Entity Type:Organization
Organization Name:LAWRENCE HEALTH SERVICE
Other - Org Name:HOXIE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-886-1275
Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:1309 WEST MAIN STREET
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-0839
Mailing Address - Country:US
Mailing Address - Phone:870-886-4711
Mailing Address - Fax:870-886-4708
Practice Address - Street 1:505 SE LINDSEY ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:AR
Practice Address - Zip Code:72433
Practice Address - Country:US
Practice Address - Phone:870-886-4711
Practice Address - Fax:870-886-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
5C447Medicare ID - Type Unspecified