Provider Demographics
NPI:1194257642
Name:PEEK IN THE POD
Entity type:Organization
Organization Name:PEEK IN THE POD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:SHERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-358-7979
Mailing Address - Street 1:2720 N WOODS LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6709
Mailing Address - Country:US
Mailing Address - Phone:479-358-7979
Mailing Address - Fax:
Practice Address - Street 1:2720 N WOODS LN
Practice Address - Street 2:SUITE C
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6709
Practice Address - Country:US
Practice Address - Phone:479-358-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile