Healthcare Provider Details

I. General information

NPI: 1578487633
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 HOSPITAL DR STE 113
MOUNTAIN HOME AR
72653-2953
US

IV. Provider business mailing address

PO BOX 707
MOUNTAIN HOME AR
72654-0707
US

V. Phone/Fax

Practice location:
  • Phone: 870-425-3291
  • Fax: 870-508-1359
Mailing address:
  • Phone: 870-424-7070
  • Fax: 870-424-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DEBRA HENRY
Title or Position: CFO
Credential:
Phone: 870-508-1003