Healthcare Provider Details

I. General information

NPI: 1972733087
Provider Name (Legal Business Name): CORNING NURSING & REHAB CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 N MISSOURI
CORNING AR
72422-2000
US

IV. Provider business mailing address

831 N MISSOURI
CORNING AR
72422-2000
US

V. Phone/Fax

Practice location:
  • Phone: 870-368-4050
  • Fax: 870-368-4054
Mailing address:
  • Phone: 870-368-4050
  • Fax: 870-368-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number893
License Number StateAR

VIII. Authorized Official

Name: BOBBY HARGIS
Title or Position: PRESIDENT
Credential:
Phone: 870-368-4050