Healthcare Provider Details

I. General information

NPI: 1851525463
Provider Name (Legal Business Name): DEWITT HOSPITAL & NURSING HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 MADISON ST
CLARENDON AR
72029-0000
US

IV. Provider business mailing address

P.O. BOX 32
DEWITT AR
72042-0000
US

V. Phone/Fax

Practice location:
  • Phone: 870-946-3571
  • Fax:
Mailing address:
  • Phone: 870-946-3571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY MORSE
Title or Position: ADMINISTRATOR & CEO
Credential:
Phone: 870-946-3571