LAVACA WELLNESS CLINIC, P.A. (NPI# 1821390287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821390287 |
Entity Type | Organization |
Organization Name | LAVACA WELLNESS CLINIC, P.A. |
Practice Address |
603 S Division St Lavaca AR 72941-4129 |
Practice Telephone | 4796749181 |
Practice Fax Number | 4796748105 |
Mailing Telephone | 4796749181 |
Mailing Fax Number | 4796748105 |
Enumeration Date | 2010-11-17 |
Last Update Date | 2010-11-17 |
Authorized Official Name | ROBERT E. SANDERS (OWNER) |
Authorized Official Telephone | 4794627203 |
Authorized Official Credential | D.O. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
603 S DIVISION ST |
City | LAVACA |
State | AR |
Zip Code | 72941-4129 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932188216 | Robert E. Sanders | Internal Medicine | 603 S Division St, Suite A, Lavaca, AR 72941 | 2006-01-13 |
1902452345 | River Valley Primary Care Services | Clinic/Center | 603 S Division St, Lavaca, AR 72941-4129 | 2019-08-12 |
1780990408 | Kelly Jo Hubbard | Nurse Practitioner | 603 S Division St, Lavaca, AR 72941-4129 | 2010-08-19 |
1275774440 | Jonathan Rene Broniste | Nurse Practitioner | 603 S Division St, Lavaca, AR 72941-4129 | 2009-03-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265804389 | Cynthia Leach | Social Worker | 604 Tiffany Drive, Lavaca, AR 72941 | 2015-10-28 |
1154725067 | Health-wise Pharmacy, Pllc | Pharmacy | 1800 West Main, Lavaca, AR 72941 | 2014-10-21 |
1215065974 | Lavaca School District | Local Education Agency (LEA) | 203 Fir Street, Lavaca, AR 72941 | 2007-03-02 |
1245838580 | Ciara Fleer | Occupational Therapist | 1408 Nixon Rd, Lavaca, AR 72941-3116 | 2020-10-09 |
1407024045 | Lavaca Family Clinic | Clinic/Center | 1000 W Main St, Lavaca, AR 72941-3530 | 2008-02-18 |
1154388999 | Area Agency On Aging of Western Arkansas, Inc | Hospice Care, Community Based | 500 S Division St, Lavaca, AR 72941-4126 | 2006-04-26 |
1508823113 | Area Agency On Aging of Western Arkansas, Inc | Home Health | 500 S Division St, Lavaca, AR 72941-4126 | 2006-04-27 |
1588997100 | James A Finley Jr. | Dentist | 1716 Fred Patterson Dr, Central City, AR 72941-6009 | 2009-09-14 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407024045 | Lavaca Family Clinic | Clinic/Center | 1000 W Main St, Lavaca, AR 72941-3530 | 2008-02-18 |
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1083273007 | Diane K Bodemann Md Ltd | Clinic/Center | 256 Grandstaff Dr, Hot Springs, AR 71913-8789 | 2019-06-12 |
1265098552 | Community Family Medical LLC | Clinic/Center | 1139 North Highway 77, Marion, AR 72364-9027 | 2019-05-13 |
1174187132 | Arcare | Clinic/Center | 3800 Rogers Ave Ste 6, Fort Smith, AR 72903-3075 | 2019-04-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.