Basic Information
| Provider Information | |||||||||
| NPI: | 1831374255 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARTI ONCOLOGY SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55050 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722155050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019063000 | ||||||||
| FaxNumber: | 5019078367 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 CARTI WAY | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016648573 | ||||||||
| FaxNumber: | 5012963200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2008 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| AuthorizedOfficialLastName: | HEAD | ||||||||
| AuthorizedOfficialFirstName: | ADAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5019063000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 175744002 | 05 | AR | MEDICAID | DO0468 | 01 | AR | RAILROAD MEDICARE - B | OTHER |