COMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE (COMMUNITY MEDICAL CENTER OF IZARD COUNTY) NPI 1023065117

Clinic/Center (Rural Health) in Melbourne, AR

NPI 1023065117 Organization Clinic/Center Rural Health

About COMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE (COMMUNITY MEDICAL CENTER OF IZARD COUNTY)

Community Medical Center Clinic Of Melbourne (community Medical Center Of Izard County) is a primary care provider established in Melbourne, Arkansas specializing in clinic/center (rural health) . The NPI number of Community Medical Center Clinic Of Melbourne (community Medical Center Of Izard County) is 1023065117 and was assigned on May 2006. The practitioner's primary taxonomy code is 261QR1300X with license number AR3931 (AR). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Community Medical Center Clinic Of Melbourne. The authorized official of this NPI record is Dr. Ted Topolewski Ceo/cfo (Administrator)

A primary care provider (PCP) like Community Medical Center Clinic Of Melbourne sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

NPI

1023065117

Provider NameCOMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE (COMMUNITY MEDICAL CENTER OF IZARD COUNTY)
Provider Location Address203 TATE SPRINGS RD MELBOURNE, AR 72556
Provider Mailing Address203 TATE SPRINGS RD MELBOURNE, AR 72556
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameCOMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE
Other Name TypeDoing Business As (3)
Enumeration Date05-27-2006
Last Update Date09-04-2012


Primary Taxonomy

Taxonomy Code261QR1300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRural Health
License No.AR3931
License StateAR

Business Address

COMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE
203 TATE SPRINGS RD
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-1911
Fax: (870) 368-1910

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Mailing Address

COMMUNITY MEDICAL CENTER CLINIC OF MELBOURNE
203 TATE SPRINGS RD
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-1911
Fax: (870) 368-1910



Authorized Official

Authorized Official NameDR. TED TOPOLEWSKI CEO/CFO
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(870) 297-2400

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
175237729MEDICAID (05)AR
5G879MEDICARE PIN (08)AR
5B958OTHER (01)AR
043498MEDICARE OSCAR/CERTIFICATION (06)AR

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.