Healthcare Provider Details

I. General information

NPI: 1720430309
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E CRANDALL AVE STE A
HARRISON AR
72601-3628
US

IV. Provider business mailing address

114 E CRANDALL AVE STE A
HARRISON AR
72601-3628
US

V. Phone/Fax

Practice location:
  • Phone: 870-365-0130
  • Fax: 870-565-0131
Mailing address:
  • Phone: 870-365-0130
  • Fax: 870-565-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateAR

VIII. Authorized Official

Name: DEBRA HENRY
Title or Position: CFO
Credential:
Phone: 870-508-1003