Healthcare Provider Details

I. General information

NPI: 1881795789
Provider Name (Legal Business Name): EUREKA SPRINGS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FOREST PARK SUITE D & E
HOLIDAY ISLAND AR
72631
US

IV. Provider business mailing address

24 NORRIS ST
EUREKA SPRINGS AR
72632-3541
US

V. Phone/Fax

Practice location:
  • Phone: 479-253-5554
  • Fax: 479-253-7708
Mailing address:
  • Phone: 479-253-7400
  • Fax: 479-363-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberAR4254
License Number StateAR

VIII. Authorized Official

Name: MR. JAMES D. WHEELER JR.
Title or Position: CEO
Credential:
Phone: 479-253-7400