1003160771 NPI number — DUBUIS HEALTH SYSTEM, INC.

Table of content: (NPI 1003160771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003160771 NPI number — DUBUIS HEALTH SYSTEM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUBUIS HEALTH SYSTEM, 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:
ADVANCE CARE HOSPITAL OF HOT SPRINGS
Provider Other Organization Name Type Code:
3
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:
1003160771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 WERNER ST
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
HOT SPRINGS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71913-6406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-609-4300
Provider Business Mailing Address Fax Number:
501-609-4335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 WERNER ST
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71913-6406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-609-4300
Provider Business Practice Location Address Fax Number:
501-609-4335
Provider Enumeration Date:
11/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MILLS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
713-277-2334

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 197589105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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