Healthcare Provider Details

I. General information

NPI: 1982149662
Provider Name (Legal Business Name): BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 DOGWOOD HOLLOW RD
MOUNTAIN VIEW AR
72560-8626
US

IV. Provider business mailing address

PO BOX 1060
MARSHALL AR
72650-1060
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax: 999-999-9999
Mailing address:
  • Phone: 870-448-5101
  • Fax: 870-448-3767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE ACKERSON
Title or Position: CEO
Credential:
Phone: 870-448-5733