Healthcare Provider Details

I. General information

NPI: 1750402806
Provider Name (Legal Business Name): HOWARD MEMORIAL HOSPITAL HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 LESLIE ST SUITE 4
NASHVILLE AR
71852-4017
US

IV. Provider business mailing address

PO BOX 381
NASHVILLE AR
71852-0381
US

V. Phone/Fax

Practice location:
  • Phone: 870-845-8206
  • Fax: 870-451-9741
Mailing address:
  • Phone: 870-845-8206
  • Fax: 870-451-9741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAR4223
License Number StateAR

VIII. Authorized Official

Name: MR. BRIAN BICKEL
Title or Position: CEO
Credential:
Phone: 870-845-8206