# CONWAY REGIONAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Conway Regional Medical Clinic-Vilonia
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063798858
- **Authorized official:** WILLIAM PACK (CFO)
- **Authorized official phone:** (501) 450-2112

## Contact information

- **Practice address:** 1159 MAIN ST, VILONIA, AR 72173-9525
- **Practice address phone:** (501) 796-8484
- **Practice address fax:** (501) 796-2453
- **Mailing address:** PO BOX 9662, CONWAY, AR 72033-9662
- **Mailing address phone:** (501) 852-1363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | E5175 | AR | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 11/09/2023