1861711301 NPI number — MCGEHEE HOSPITAL INCORPORATED

Table of content: (NPI 1861711301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861711301 NPI number — MCGEHEE HOSPITAL INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCGEHEE HOSPITAL INCORPORATED
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:
1861711301
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 351
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC GEHEE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71654-0351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-222-5600
Provider Business Mailing Address Fax Number:
870-222-4260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 S 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC GEHEE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71654-2562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-222-5600
Provider Business Practice Location Address Fax Number:
870-690-4239
Provider Enumeration Date:
05/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
AMSTUTZ
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
870-690-4132

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AR4657 . This is a "LICENSE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1Z308 . This is a "BLUE CROSS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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