# SPARKS MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greenwood Family Medicine Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104920644
- **Authorized official:** REBECCA COX (CBO SUPPORT MANAGER)
- **Authorized official phone:** (479) 709-7057

## Contact information

- **Practice address:** 1480 W CENTER ST, GREENWOOD, AR 72936-3449
- **Practice address phone:** (479) 996-5585
- **Practice address fax:** (479) 996-5386
- **Mailing address:** PO BOX 2420, FORT SMITH, AR 72902-2420
- **Mailing address phone:** (479) 709-7399
- **Mailing address fax:** (479) 709-7053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4454530002 | M-CARE DME | AR |