MEDICARE: PIKE COUNTY MEMORIAL HOSPITAL-SB

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
1	275N00000X	Medicare Defined Swing Bed Hospital Unit	82	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10081	OTHER	AR	BCBS ID #

General Provider Information

NPI Number	:	1073616462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIKE COUNTY MEMORIAL HOSPITAL-SB

Provider Business Mailing Address
First Line	:	PO BOX F
Second Line	:
City	:	MURFREESBORO
State	:	AR
Zip	:	71958-1005
Country	:	US
Telephone Number	:	870-285-3182
Fax Number	:	870-285-3305

Provider Business Practice Location Address
First Line	:	315 E 13TH ST
Second Line	:
City	:	MURFREESBORO
State	:	AR
Zip	:	71958-9541
Country	:	US
Telephone Number	:	870-285-3182
Fax Number	:	870-285-3305

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ROSEMARY FRITTS
Credential	:
Telephone Number	:	870-285-3182

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	08/22/2020

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Directions to “PIKE COUNTY MEMORIAL HOSPITAL-SB ” Practice Location

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