Healthcare Provider Details

I. General information

NPI: 1386199057
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 HIGHWAY 5 N SUITE 10
MOUNTAIN HOME AR
72653-3027
US

IV. Provider business mailing address

230 HIGHWAY 5 N SUITE 10
MOUNTAIN HOME AR
72653-3027
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-0517
  • Fax: 870-424-0514
Mailing address:
  • Phone: 870-424-0517
  • Fax: 870-424-0514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES RUDY DARLING
Title or Position: VP OPERATIONS
Credential: RPH, MBA
Phone: 870-508-1002