Healthcare Provider Details

I. General information

NPI: 1508877697
Provider Name (Legal Business Name): PIGGOTT COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E MAIN ST
PIGGOTT AR
72454-2725
US

IV. Provider business mailing address

1206 GORDON DUCKWORTH DR
PIGGOTT AR
72454-1911
US

V. Phone/Fax

Practice location:
  • Phone: 870-598-3881
  • Fax: 870-598-5915
Mailing address:
  • Phone: 870-598-3881
  • Fax: 870-598-5915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number9947
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG00327
License Number StateAR

VIII. Authorized Official

Name: MR. JAMES L MAGEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-598-3881