Healthcare Provider Details

I. General information

NPI: 1407061237
Provider Name (Legal Business Name): WHITE RIVER RURAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 CHURCH STREET
PARKIN AR
72373
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 870-755-2838
  • Fax: 870-755-2840
Mailing address:
  • Phone: 870-347-3371
  • Fax: 870-347-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAR20255
License Number StateAR

VIII. Authorized Official

Name: STERVEN F. COLLIER
Title or Position: CEO
Credential:
Phone: 870-347-3304