# LITTLE RIVER MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LITTLE RIVER MEDICAL CENTER, INC.
- **Other names:** Memorial Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962719856
- **Legal business name:** LITTLE RIVER MEDICAL CENTER, INC.
- **Authorized official:** MRS. VICKI ANN KEENER (ADM. ASSISTANT)
- **Authorized official phone:** (870) 898-5011

## Contact information

- **Practice address:** 370 W MAIN ST, ASHDOWN, AR 71822-2750
- **Practice address phone:** (870) 898-4100
- **Practice address fax:** (870) 898-5791
- **Mailing address:** 450 W LOCKE ST, SUITE C, ASHDOWN, AR 71822-3326
- **Mailing address phone:** (870) 898-5011
- **Mailing address fax:** (870) 898-4172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/13/2010
- **Last updated:** 11/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 191446002 | — | AR |
| 01 | — | 5G384 | BCS | AR |