Healthcare Provider Details

I. General information

NPI: 1083718241
Provider Name (Legal Business Name): FORREST CITY ARKANSAS HOSPITAL COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NEWCASTLE RD
FORREST CITY AR
72335
US

IV. Provider business mailing address

PO BOX 504293
SAINT LOUIS MO
63150-4293
US

V. Phone/Fax

Practice location:
  • Phone: 870-261-0000
  • Fax: 870-261-0405
Mailing address:
  • Phone: 870-261-0000
  • Fax: 870-261-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: RANDY MICHAEL COOPER
Title or Position: SVP FINANCE OPERATIONS
Credential:
Phone: 615-221-3840