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NPI Code Detail

MEDICARE: MERCY HOSPITAL WALDRON

MEDICARE: MERCY HOSPITAL WALDRON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25B332OTHERARBLUECROSS BLUESHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043268451
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY HOSPITAL WALDRON
Provider Business Mailing Address
First Line : 5401 ELLSWORTH RD
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-3219
Country : US
Telephone Number : 479-314-1101
Fax Number : 479-314-4704
Provider Business Practice Location Address
First Line : 1341 W 6TH ST
Second Line :
City : WALDRON
State : AR
Zip : 72958-7642
Country : US
Telephone Number : 479-637-2136
Fax Number : 479-637-5411
Authorized Official
Title or Position : VP FINANCE MERCY CAH
Name : SHERRY LYNN CLOUSE DAY
Credential :
Telephone Number : 417-820-8439
Provider Enumeration Date : 05/05/2006
Last Update Date : 02/17/2021

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Directions to “MERCY HOSPITAL WALDRON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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