MEDICARE: MERCY HOSPITAL FORT SMITH

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	251G00000X	Community Based Hospice Care Agency	412	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11504	OTHER	AR	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356312292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HOSPITAL FORT SMITH

Provider Business Mailing Address
First Line	:	7301 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4100
Country	:	US
Telephone Number	:	479-314-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4067
Country	:	US
Telephone Number	:	479-573-3866
Fax Number	:	479-573-3867

Authorized Official
Title or Position	:	VICE PRESIDENT FINANCE
Name	:	MS. GRETA WILCHER
Credential	:
Telephone Number	:	479-314-6100

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/20/2022

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Directions to “MERCY HOSPITAL FORT SMITH ” Practice Location

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