Healthcare Provider Details

I. General information

NPI: 1588833214
Provider Name (Legal Business Name): ST. JOSEPH'S MERCY CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 HIGDON FERRY RD SUITE B
HOT SPRINGS AR
71913-6419
US

IV. Provider business mailing address

PO BOX 21850
HOT SPRINGS AR
71903-1850
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-2731
  • Fax: 501-623-1660
Mailing address:
  • Phone: 501-609-2229
  • Fax: 501-321-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TERRY D BROWN
Title or Position: COO
Credential:
Phone: 501-609-2229