Healthcare Provider Details

I. General information

NPI: 1760418842
Provider Name (Legal Business Name): JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 SOUTH SCENIC 7 DRIVE
OLA AR
72853
US

IV. Provider business mailing address

PO BOX 639
DANVILLE AR
72833-0639
US

V. Phone/Fax

Practice location:
  • Phone: 479-489-5126
  • Fax: 479-489-5174
Mailing address:
  • Phone: 479-489-5126
  • Fax: 479-489-5174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCOTT PEEK
Title or Position: CEO
Credential:
Phone: 479-495-2241