EXECUTIVE PARK SURGERY CENTER, LLC
NPI 1699736777
Clinic/Center - Ambulatory Surgical in Fort Smith, AR
About Executive Park Surgery Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EXECUTIVE PARK SURGERY CENTER, LLC (NPI 1699736777) is a healthcare organization registered as an ambulatory surgical in Fort Smith, Arkansas and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through February 8, 2028 and lists Randy M Ennen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 04D1022158
Executive Park Surgery Center Of Fort Smith, Inc Dba Executive Park Surgery Center · Fort Smith, AROther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT SMITH, AR 72903
FORT SMITH, AR 72903
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699736777, enumerated as an "organization" on March 29, 2006.
The provider is located at 3314 S 70TH ST FORT SMITH, AR 72903 and the phone number is (479) 424-2744.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
