Organization
CONWAY REGIONAL MEDICAL CENTER INC
Active
Other names
GREENBRIER FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PACK (CFO)
(501) 450-2112
Entity
Organization
Contact information
Practice address
110 N BROADVIEW, GREENBRIER, AR 72058-9475
(501) 679-3551
(501) 679-4536
Mailing address
PO BOX 9662, CONWAY, AR 72033-9662
(501) 852-1363
(501) 852-1364
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126870002
—
AR
05
—
128443729
—
AR
Enumeration date
09/02/2006
Last updated
11/09/2023
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