Healthcare Provider Details

I. General information

NPI: 1265629851
Provider Name (Legal Business Name): EUREKA SPRINGS HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NORRIS ST
EUREKA SPRINGS AR
72632-3541
US

IV. Provider business mailing address

24 NORRIS ST
EUREKA SPRINGS AR
72632-3541
US

V. Phone/Fax

Practice location:
  • Phone: 318-226-8202
  • Fax: 318-226-8205
Mailing address:
  • Phone: 479-253-7400
  • Fax: 479-363-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: JODI EDMONDSON
Title or Position: HR DIRECTOR
Credential:
Phone: 479-253-7400