Basic Information
| Provider Information | |||||||||
| NPI: | 1205425352 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CARTI CANCER CENTERS, INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55050 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722155050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019063000 | ||||||||
| FaxNumber: | 5019076522 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 CARTI WAY | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019063000 | ||||||||
| FaxNumber: | 5019076522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2021 | ||||||||
| LastUpdateDate: | 02/01/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STYRON | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO/EVP | ||||||||
| AuthorizedOfficialTelephone: | 5012963232 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE | ||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 02/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.