LEE COUNTY COOPERATIVE CLINIC NPI 1669480836

Clinic/Center (Federally Qualified Health Center (FQHC)) in Marianna, AR

NPI 1669480836 Organization Clinic/Center Federally Qualified Health Center (FQHC) CLIA Number 04D0701209 CLIA Certificate of Waiver

About LEE COUNTY COOPERATIVE CLINIC

Lee County Cooperative Clinic is a primary care provider established in Marianna, Arkansas specializing in clinic/center (federally qualified health center (fqhc)) . The NPI number of Lee County Cooperative Clinic is 1669480836 and was assigned on August 2006. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated September 2021. The authorized official of this NPI record is Miss Ossie M Hall (Cashier/billing Supervisor)

A primary care provider (PCP) like Lee County Cooperative 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 Lee County Cooperative Clinic is 04D0701209 registered as a "rural health clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Lee County Cooperative Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1669480836

Provider NameLEE COUNTY COOPERATIVE CLINIC
Provider Location Address530 WEST ATKINS BLVD MARIANNA, AR 72360
Provider Mailing AddressPO BOX 669 MARIANNA, AR 72360
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date08-04-2006
Last Update Date09-21-2021


Primary Taxonomy

Taxonomy Code261QF0400X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationFederally Qualified Health Center (FQHC)

Business Address

LEE COUNTY COOPERATIVE CLINIC
530 WEST ATKINS BLVD
MARIANNA, AR
ZIP 72360
Phone: (870) 295-5225
Fax: (870) 295-6900

Get Directions


Mailing Address

LEE COUNTY COOPERATIVE CLINIC
PO BOX 669
MARIANNA, AR
ZIP 72360
Phone: (870) 295-5225
Fax: (870) 295-6900



Authorized Official

Authorized Official NameMISS OSSIE M HALL
Authorized Official TitleCASHIER/BILLING SUPERVISOR
Authorized Official Phone(870) 295-5225

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 1669480836 is:

CLIA Number04D0701209
Facility TypeRURAL HEALTH CLINIC
Certificate TypeCertificate of Waiver

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
5G122OTHER (01)AR
117597749MEDICAID (05)AR

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093093247 VALENTINE C EMECHETE DENTIST
Individual
Dentist530 WEST ATKINS BLVD
MRIANNA, AR 72360
(870) 295-5225

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.