Healthcare Provider Details

I. General information

NPI: 1194776757
Provider Name (Legal Business Name): ARKANSAS CHILDRENS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS WAY
LITTLE ROCK AR
72202-3500
US

IV. Provider business mailing address

PO BOX 959794
SAINT LOUIS MO
63195-9794
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-2526
  • Fax:
Mailing address:
  • Phone: 501-364-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: SHERYL PHILLIPS
Title or Position: AR CONTROL MANAGER
Credential:
Phone: 501-364-2526