Healthcare Provider Details

I. General information

NPI: 1376596569
Provider Name (Legal Business Name): WOMENS CENTER OF NORTHWEST ARKANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GREATHOUSE RD.
JOHNSON AR
72741
US

IV. Provider business mailing address

PO BOX 841278
DALLAS TX
75284-1278
US

V. Phone/Fax

Practice location:
  • Phone: 479-684-3000
  • Fax: 479-684-3075
Mailing address:
  • Phone: 479-684-3000
  • Fax: 479-684-3075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number3904
License Number StateAR

VIII. Authorized Official

Name: REBECCA HURLEY
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 214-473-7000