Healthcare Provider Details

I. General information

NPI: 1396779278
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 RYAN ROAD
COTTER AR
72626-9175
US

IV. Provider business mailing address

30 RYAN ROAD
COTTER AR
72626-9175
US

V. Phone/Fax

Practice location:
  • Phone: 870-435-7500
  • Fax: 870-435-7509
Mailing address:
  • Phone: 870-435-7500
  • Fax: 870-435-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAR3867
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAR

VIII. Authorized Official

Name: DEBRA HENRY
Title or Position: CFO
Credential:
Phone: 870-508-1003