Organization
CONWAY REGIONAL MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE COTHRAN (MANAGER)
(501) 745-2122
Entity
Organization
Contact information
Practice address
2302 COLLEGE AVE, CONWAY, AR 72034
(501) 329-3831
(501) 450-2363
Mailing address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 329-3831
(501) 450-2363
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0607495
AETNA
AR
01
—
10015
CIGNA
AR
01
—
10029
BLUE CROSS BLUE SHIELD
AR
05
—
102178105
—
AR
01
—
107347
HEALTHLINK-HMO
AR
01
—
124633
UNITED HEALTHCARE
AR
Enumeration date
08/06/2012
Last updated
06/26/2018
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