Organization
LAWRENCE MEMORIAL HEALTH FOUNDATION INC.
Active
Other names
Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA K WAGNER (CFO)
(870) 886-1263
Entity
Organization
Contact information
Practice address
1309 W MAIN ST, WALNUT RIDGE, AR 72476-1430
(870) 886-3211
(870) 886-9027
Mailing address
PO BOX 839, WALNUT RIDGE, AR 72476-0839
(870) 886-3211
(870) 886-9027
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234112729
—
AR
Enumeration date
09/09/2005
Last updated
07/21/2020
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