STATELINE MEDICAL AR LLC (NPI# 1568949436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568949436 |
| Entity Type | Organization |
| Organization Name | STATELINE MEDICAL AR LLC |
| Practice Address |
12204 W Highway 62 Farmington AR 72730-9560 |
| Mailing Address |
17 Belhaven View Ct Fort Smith AR 72908-9063 |
| Practice Telephone | 4795612448 |
| Mailing Telephone | 4796509459 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Authorized Official Name | BRITTANY FOX (CO-OWNER) |
| Authorized Official Telephone | 4796509459 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
12204 W HIGHWAY 62 |
| City | FARMINGTON |
| State | AR |
| Zip Code | 72730-9560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073706370 | Exceed Physical Therapy, Inc. | Physical Therapist | 95 S Southwinds Rd, Suite 1, Farmington, AR 72730 | 2007-08-21 |
| 1134288228 | Melanie Nicole Alberty | Physical Therapy Assistant | 91 Neal, Farmington, AR 72730 | 2006-12-06 |
| 1689687329 | Terri Lynn Pinkham | Occupational Therapist | 91 E Neal, Hope for Tomorrow Pediatric Foundation, Farmington, AR 72730 | 2006-08-14 |
| 1497768139 | Pamela K Petray | Speech-Language Pathologist | 91 Neal St, Hope for Tomorrow, Farmington, AR 72730 | 2006-08-14 |
| 1790202596 | Chelsea Kaitlyn Coffelt | Occupational Therapist | 4 N Double Springs Rd, Farmington, AR 72730 | 2017-08-23 |
| 1083151104 | Zoe Loretta Allgood Mcgee | Speech-Language Pathologist | 4 N Double Springs Rd, Farmington, AR 72730 | 2017-01-26 |
| 1467869248 | Bridget Starnes | Occupational Therapist | 120 Southwinds Rd Ste 2, Farmington, AR 72730 | 2014-07-14 |
| 1669694139 | Nancy Marie Whitten | Speech-Language Pathologist | 91 Neal, Hope for Tomorrow, Farmington, AR 72730 | 2007-05-03 |
| 1538292305 | Robert Lee Brewer | Dentist | 19 West Main St, Farmington, AR 72730 | 2007-03-13 |
| 1295835122 | Rickie Lynn Porter | Pharmacist | 197 E Main St, Farmington, AR 72730 | 2006-09-22 |
| Find all providers in zip 72730 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
| 1609205483 | The Jackson Laboratory | Clinical Medical Laboratory | 10 Discovery Dr, Farmington, CT 06032-2374 | 2013-11-02 |
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| 1184957391 | Lovelace Health Systems Inc. Dba S.e.d. Medical Laboratories-farmingto | Clinical Medical Laboratory | 724 W Animas St, Farmington, NM 87401-5617 | 2009-09-08 |
| 1891303053 | Parkland Health Center | Clinical Medical Laboratory | 1101 W Liberty St, Farmington, MO 63640-1921 | 2020-07-14 |
| 1013348523 | Presbyterian Medical Services | Clinical Medical Laboratory | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2013-12-09 |
| 1891978219 | The Center for Advanced Reproductive Services, PC | Clinical Medical Laboratory | 2 Batterson Park Rd, Farmington, CT 06032-2568 | 2007-12-07 |
| 1811047210 | Cascade Laboratory | Clinical Medical Laboratory | 33750 Freedom Rd, Farmington, MI 48335-4755 | 2007-01-10 |
| 1427031293 | University Dentists | Clinical Medical Laboratory | 263 Farmington Ave, Oral Pathology Laboratory, Farmington, CT 06030-0001 | 2005-11-25 |
| 1336122100 | University of Connecticut Health Center | Clinical Medical Laboratory | 21 South Rd, Dermatopathology Laboratory, Farmington, CT 06032-2482 | 2005-11-25 |
| 1558344721 | University of Connecticut Health Center | Clinical Medical Laboratory | 263 Farmington Ave, Cytogenetics Laboratory, Farmington, CT 06030-0001 | 2005-11-22 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 72730 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.