Healthcare Provider Details

I. General information

NPI: 1043276942
Provider Name (Legal Business Name): DEWITT HOSPITAL & NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 S WHITEHEAD DR
DE WITT AR
72042-2994
US

IV. Provider business mailing address

PO BOX 392
DE WITT AR
72042-0392
US

V. Phone/Fax

Practice location:
  • Phone: 870-946-3637
  • Fax: 877-353-0981
Mailing address:
  • Phone: 870-946-2971
  • Fax: 870-946-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROL ANNE ROWLAND
Title or Position: CLINIC MANAGER
Credential:
Phone: 870-946-3637