Healthcare Provider Details

I. General information

NPI: 1942237268
Provider Name (Legal Business Name): JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 10 EAST
DANVILLE AR
72833-0639
US

IV. Provider business mailing address

PO BOX 639
DANVILLE AR
72833-0639
US

V. Phone/Fax

Practice location:
  • Phone: 479-495-2241
  • Fax: 479-495-6289
Mailing address:
  • Phone: 479-495-2241
  • Fax: 479-495-6289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAR3644
License Number StateAR

VIII. Authorized Official

Name: M SCOTT PEEK
Title or Position: CEO
Credential:
Phone: 479-495-2241