CCN: 047088 NPI: 1073595625 Organization

INTREPID USA HEALTHCARE SERVICES

109 KIMBERLY ST.
MCCRORY, AR 721010365

Contact Information

Phone 8707315441
Fax 8707312613
Enumeration Date 2005-11-18
Last Updated 2022-11-07

Taxonomies

Code: 251E00000X (Primary) License State: AR License: AR4685

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 04

providerType 36

specialPaymentIndicator

carrierCode 07102

localityCode 13