Healthcare Provider Details

I. General information

NPI: 1356322309
Provider Name (Legal Business Name): LITTLE RIVER MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 S 4TH ST
ASHDOWN AR
71822-3302
US

IV. Provider business mailing address

170 S 4TH ST
ASHDOWN AR
71822-3302
US

V. Phone/Fax

Practice location:
  • Phone: 870-898-4120
  • Fax: 870-898-3219
Mailing address:
  • Phone: 870-898-4120
  • Fax: 870-898-3219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES DOWELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 870-898-5011