Jeremiah Brewer, MHPP

Individual provider Active NPI Case Manager/Care Coordinator · Mena, AR

NPI 1710197371 · NPPES record last updated Sep 17, 2008

Key facts

NPI
1710197371
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1210 Dequeen St
Mena, AR 71953-4132
Phone
(479) 394-3200
Fax
(479) 394-3205
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1210 Dequeen St
Mena, AR 71953-4132

Mailing address

1210 Dequeen St
Mena, AR 71953-4132
Phone (479) 394-3200

Other providers in Mena, AR

All providers in Mena, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.