Healthcare Provider Details

I. General information

NPI: 1184695926
Provider Name (Legal Business Name): MERCY HOSPITAL FORT SMITH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

IV. Provider business mailing address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-6100
  • Fax:
Mailing address:
  • Phone: 479-314-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number412
License Number StateAR

VIII. Authorized Official

Name: MS. GRETA WILCHER
Title or Position: SENIOR VICE PRESIDENT/ CFO
Credential:
Phone: 479-314-6100