Healthcare Provider Details

I. General information

NPI: 1346354826
Provider Name (Legal Business Name): OUACHITA COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
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

Practice location:
  • Phone: 870-836-1387
  • Fax: 870-836-1358
Mailing address:
  • Phone: 870-836-1338
  • Fax: 870-836-1358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. ROBERT ANDERS
Title or Position: CFO
Credential:
Phone: 870-836-1387