1851484695 NPI number — HOWARD MEMORIAL HOSPITAL

Table of content: (NPI 1851484695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851484695 NPI number — HOWARD MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD MEMORIAL HOSPITAL
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:
1851484695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 MEDICAL CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71852
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-845-4400
Provider Business Mailing Address Fax Number:
870-845-8027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 MEDICAL CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-845-4400
Provider Business Practice Location Address Fax Number:
870-845-8027
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOYD
Authorized Official First Name:
LYNNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
PFS DIRECTOR
Authorized Official Telephone Number:
870-845-8024

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  AR3890 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 122805514 . This is a "MEDICAID HOME HEALTH SKIL" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 011311 . This is a "BLUE CROSS HOSPITAL" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 102665105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 770008505 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 137331742 . This is a "MEDICAID HOME HEALTH OT S" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 131556716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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