Healthcare Provider Details

I. General information

NPI: 1972600187
Provider Name (Legal Business Name): COMMUNITY MEDICAL CENTER OF IZARD COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 THIRD ST
HORSESHOE BEND AR
72512-3736
US

IV. Provider business mailing address

PO BOX 438
CALICO ROCK AR
72519-0438
US

V. Phone/Fax

Practice location:
  • Phone: 870-670-5115
  • Fax: 870-670-4455
Mailing address:
  • Phone: 870-297-2449
  • Fax: 870-297-4161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberAR3931
License Number StateAR

VIII. Authorized Official

Name: DR. THEODORE TOPOLEWSKI
Title or Position: ADMINISTRATOR
Credential: CEO/CFO
Phone: 870-297-2400