Provider Demographics
NPI:1366922320
Name:MERCY NORTHWEST ARKANSAS AMBULATORY SERVICES LLC
Entity type:Organization
Organization Name:MERCY NORTHWEST ARKANSAS AMBULATORY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP- ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-364-3891
Mailing Address - Street 1:2710 S RIFE MEDICAL LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:314-628-3608
Mailing Address - Fax:
Practice Address - Street 1:4962 ELM SPRINGS ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-318-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care