1215335435 NPI number — WHITE COUNTY MEDICAL CENTER

Table of content: (NPI 1215335435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215335435 NPI number — WHITE COUNTY MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITE COUNTY MEDICAL CENTER
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:
6
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:
1215335435
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 HAWKINS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEARCY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72143-4802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-362-5800
Provider Business Mailing Address Fax Number:
501-362-5818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2725 HIGHWAY 25B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEBER SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72543-6306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-362-5800
Provider Business Practice Location Address Fax Number:
501-268-7327
Provider Enumeration Date:
12/22/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
STUART
Authorized Official Middle Name:
Authorized Official Title or Position:
VP TREASURER
Authorized Official Telephone Number:
501-203-2188

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 210172002 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com