MELBOURNE MEDICAL CLINIC (WHITE RIVER HEALTH SYSTEM, INC.) NPI 1477523348

Clinic/Center (Rural Health) in Melbourne, AR

NPI 1477523348 Organization Clinic/Center Rural Health CLIA Number 04D0468315 CLIA Certificate of Compliance

About MELBOURNE MEDICAL CLINIC (WHITE RIVER HEALTH SYSTEM, INC.)

Melbourne Medical Clinic (white River Health System, Inc.) is a primary care provider established in Melbourne, Arkansas specializing in clinic/center (rural health) . The NPI number of Melbourne Medical Clinic (white River Health System, Inc.) is 1477523348 and was assigned on January 2006. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's is doing business as Melbourne Medical Clinic. The authorized official of this NPI record is Woodrow Castleberry (Managed Care Coordin)

A primary care provider (PCP) like Melbourne Medical Clinic 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

The CLIA number of Melbourne Medical Clinic is 04D0468315 registered as a "rural health clinic" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Melbourne Medical Clinic after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

NPI

1477523348

Provider NameMELBOURNE MEDICAL CLINIC (WHITE RIVER HEALTH SYSTEM, INC.)
Provider Location Address1526 E. MAIN ST. MELBOURNE, AR 72556
Provider Mailing AddressP.O. BOX 37 MELBOURNE, AR 72556
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameMELBOURNE MEDICAL CLINIC
Other Name TypeDoing Business As (3)
Enumeration Date01-24-2006
Last Update Date02-19-2015


Primary Taxonomy

Taxonomy Code261QR1300X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRural Health

Business Address

MELBOURNE MEDICAL CLINIC
1526 E. MAIN ST.
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-4344
Fax: (870) 368-3051

Get Directions


Mailing Address

MELBOURNE MEDICAL CLINIC
P.O. BOX 37
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-4344
Fax: (870) 368-3051



Authorized Official

Authorized Official Name WOODROW CASTLEBERRY
Authorized Official TitleMANAGED CARE COORDIN
Authorized Official Phone(870) 262-1160

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1477523348 is:

CLIA Number04D0468315
Facility TypeRURAL HEALTH CLINIC
Certificate TypeCertificate of Compliance

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
5G843MEDICARE PIN (08)AR
56876OTHER (01)AR
124189729MEDICAID (05)AR
04-3997MEDICARE PIN (08)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.