1548256076 NPI number — ARKANSAS REHABILITATION SERVICES

Table of content: (NPI 1548256076)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548256076 NPI number — ARKANSAS REHABILITATION SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARKANSAS REHABILITATION SERVICES
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:
HOT SPRINGS REHABILITATION CENTER HOSPITAL
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:
1548256076
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 RESERVE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOT SPRINGS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71901-4195
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-701-6217
Provider Business Mailing Address Fax Number:
501-624-0019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 RESERVE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71901-4195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-701-6217
Provider Business Practice Location Address Fax Number:
501-624-0019
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PHILLIPS
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
MEDICAL SERVICES MANAGER
Authorized Official Telephone Number:
501-701-6217

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X , with the licence number:  107 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 283X00000X , with the licence number: 04D0642139 , 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)

  • Identifier: 111208526 . This is a "HSRC DENTAL CLINIC" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 111208526 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131458002 . This is a "PHYSICIANS CLINIC" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 169599744 . This is a "PSYCH SERVICES" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 57533 . This is a "MEDICARE PART B" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 127038126 . This is a "RSPD MEDICAID" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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