Provider Demographics
NPI:1528953692
Name:CH MSSP SERVICES AR PLLC
Entity type:Organization
Organization Name:CH MSSP SERVICES AR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-991-9276
Mailing Address - Street 1:5750 JOHNSTON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5345
Mailing Address - Country:US
Mailing Address - Phone:337-991-9276
Mailing Address - Fax:
Practice Address - Street 1:609 SW 8TH ST FL 6
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7886
Practice Address - Country:US
Practice Address - Phone:337-991-9276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty