Provider Demographics
NPI:1285304949
Name:DQH&W WALK IN FAMILY CLINIC LLC
Entity type:Organization
Organization Name:DQH&W WALK IN FAMILY CLINIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PD
Authorized Official - Phone:870-642-2400
Mailing Address - Street 1:1357 W COLLIN RAYE DR
Mailing Address - Street 2:
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-2946
Mailing Address - Country:US
Mailing Address - Phone:870-642-2400
Mailing Address - Fax:
Practice Address - Street 1:1357 W COLLIN RAYE DR
Practice Address - Street 2:
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-2946
Practice Address - Country:US
Practice Address - Phone:870-642-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DQH&W WALK IN FAMILY CLINIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-15
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty