MEDICARE: JOHN ED CHAMBERS MEMORIAL HOSPITAL, 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	275N00000X	Medicare Defined Swing Bed Hospital Unit	AR4293	AR

General Provider Information

NPI Number	:	1740217884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	PO BOX 639
Second Line	:
City	:	DANVILLE
State	:	AR
Zip	:	72833-0639
Country	:	US
Telephone Number	:	479-495-2241
Fax Number	:	479-495-6290

Provider Business Practice Location Address
First Line	:	719 DETROIT STREET
Second Line	:
City	:	DANVILLE
State	:	AR
Zip	:	72833-0639
Country	:	US
Telephone Number	:	479-495-2241
Fax Number	:	479-495-6290

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL SCOTT PEEK
Credential	:
Telephone Number	:	479-495-2241

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	09/16/2021

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