| Organization Name: | CROSSETT HEALTH FOUNDATION |
| NPI Number: | 1093084808 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP K GILMORE (CEO) |
| Mailing Address: | 319 W Parker St Hamburg |
| State: | AR US |
| Postal Code: | 716463121 |
| Phone Number: | 8708538271 |
| Fax Number: | 8703641245 |
| NPI Enumeration Date: | 12/22/2011 |
| NPI Last Update Date: | 04/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |