1427294008 NPI number — HEALTH RESOURCES OF ARKANSAS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427294008 NPI number — HEALTH RESOURCES OF ARKANSAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH RESOURCES OF ARKANSAS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427294008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 GAP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATESVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72501-8679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-793-8900
Provider Business Mailing Address Fax Number:
870-793-8959

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1109 E. MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MELBOURNE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-368-4397
Provider Business Practice Location Address Fax Number:
870-368-7828
Provider Enumeration Date:
01/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MEDLOCK
Authorized Official First Name:
BERNIS
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
870-793-8900

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com