Organization Name: | ST BERNARDS HOSPITAL INC |
NPI Number: | 1043232812 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HARRY HUTCHISON (CFO) |
Mailing Address: | 310 Falls Blvd S Wynne |
State: | AR US |
Postal Code: | 723963013 |
Phone Number: | 8702383300 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | AR4053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |