1740450352 NPI number — BAXTER COUNTY REGIONAL HOSPITAL INC.

Table of content: (NPI 1740450352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740450352 NPI number — BAXTER COUNTY REGIONAL HOSPITAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAXTER COUNTY REGIONAL HOSPITAL 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:
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:
1740450352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 BUTTERCUP DR
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
MOUNTAIN HOME
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72653-2921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-424-7072
Provider Business Mailing Address Fax Number:
870-508-1338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 BUTTERCUP DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
MOUNTAIN HOME
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72653-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-424-7072
Provider Business Practice Location Address Fax Number:
870-508-1338
Provider Enumeration Date:
03/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DARLING
Authorized Official First Name:
RUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
870-508-1018

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  E2130 , 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)





Copyright © 2007-2025 www.npivalidator.com