Healthcare Provider Details
I. General information
NPI: 1659303337
Provider Name (Legal Business Name): OUACHITA COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
638 CALIFORNIA AVE SW
CAMDEN AR
71701-4604
US
IV. Provider business mailing address
PO BOX 797
CAMDEN AR
71711-0797
US
V. Phone/Fax
- Phone: 870-836-1387
- Fax: 870-836-1358
- Phone: 870-836-1387
- Fax: 870-836-1358
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
J
ANDERS
Title or Position: CFO
Credential:
Phone: 870-836-1387