Caddo River Medical Clinic PLLC

Organization Active NPI Primary Care Clinic/Center · Glenwood, AR

NPI 1194644575 · NPPES record last updated Jul 10, 2026

Key facts

NPI
1194644575
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
CADDO RIVER MEDICAL CLINIC PLLC
Practice address
180 Highway 70 E Ste 11
Glenwood, AR 71943-8810
Phone
(870) 828-1151
NPI assigned
Jul 10, 2026
Organization subpart
No

Authorized official

Name
Rickey Edna Mack, APRN
Title
Owner
Phone
(870) 828-1151

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

180 Highway 70 E
Ste 11
Glenwood, AR 71943

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

180 Highway 70 E Ste 11
Glenwood, AR 71943-8810

Mailing address

516 Highway 8 E
Glenwood, AR 71943-9222

Other providers in Glenwood, AR

All providers in Glenwood, AR · Primary Care Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.