Olive Branch Recovery-Arkansas LLC
Emergency Medicine in Rogers, AR. Organization (NPI-2).
NPI number1245035971
StatusActive
Last updated in NPPESFeb 17, 2025
Details
- NPI
- 1245035971
- Entity type
- Organization (NPI-2)
- Legal business name
- Olive Branch Recovery-Arkansas LLC
- Organization subpart
- No
- Enumeration date
- Feb 17, 2025
- Certification date
- Feb 17, 2025
- Last updated
- Feb 17, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
Practice location
6028 W Stoney Brook Rd Ste 3Rogers, AR 72758-8180
Phone 940-220-8899
Mailing address
6028 W Stoney Brook Rd Ste 3Rogers, AR 72758-8180
Authorized official
Jacob Mumm
Owner
9402208899
Is something wrong?
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