Organization
ENDOSCOPY CENTER OF LITTLE ROCK,LLC
Active
Other names
RIC LR LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALISA PETET-MCELFRESH ADMINISTRATOR (MANAGING MEMBER)
(016) 646-9805
Entity
Organization
Contact information
Practice address
4200 N RODNEY PARHAM RD STE 203, LITTLE ROCK, AR 72212-2460
(501) 228-4445
(501) 228-0110
Mailing address
4200 N RODNEY PARHAM RD, LITTLE ROCK, AR 72212-2460
(501) 228-4445
(501) 228-0110
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154933128
—
AR
Enumeration date
11/15/2005
Last updated
12/11/2023
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