Healthcare Provider Details

I. General information

NPI: 1447206735
Provider Name (Legal Business Name): MAGNOLIA REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL DR
MAGNOLIA AR
71753-2415
US

IV. Provider business mailing address

PO BOX 629
MAGNOLIA AR
71754-0629
US

V. Phone/Fax

Practice location:
  • Phone: 870-235-3000
  • Fax: 870-235-3667
Mailing address:
  • Phone: 870-235-3000
  • Fax: 870-235-3667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. REX E JONES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 870-235-3212