Healthcare Provider Details

I. General information

NPI: 1659487932
Provider Name (Legal Business Name): PIKE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date: 07/17/2007
Reactivation Date: 02/14/2008

III. Provider practice location address

315 E 13TH ST
MURFREESBORO AR
71958-9541
US

IV. Provider business mailing address

315 EAST 13TH ST
MURFREESBORO AR
71958
US

V. Phone/Fax

Practice location:
  • Phone: 870-285-3182
  • Fax: 870-285-3305
Mailing address:
  • Phone: 870-285-3182
  • Fax: 870-285-3740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberAR3422
License Number StateAR

VIII. Authorized Official

Name: MRS. ROSEMARY FRITTS
Title or Position: ADMINISTRATOR
Credential:
Phone: 870-285-3182