MEDICARE: OUACHITA REGIONAL DIAGNOSTIC AND SURGERY CENTER, INC.

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	282N00000X	General Acute Care Hospital	AR4180	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10142	OTHER	AR	AR BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1609845346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUACHITA REGIONAL DIAGNOSTIC AND SURGERY CENTER, INC.

Provider Business Mailing Address
First Line	:	1636 HIGDON FERRY RD
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6912
Country	:	US
Telephone Number	:	501-520-2000
Fax Number	:	501-520-3736

Provider Business Practice Location Address
First Line	:	1636 HIGDON FERRY RD
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6912
Country	:	US
Telephone Number	:	501-520-2000
Fax Number	:	501-520-3736

Authorized Official
Title or Position	:	CEO
Name	:	MR. JASON SPRING
Credential	:
Telephone Number	:	501-520-2000

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	12/20/2007

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