Healthcare Provider Details

I. General information

NPI: 1033283171
Provider Name (Legal Business Name): ASSOCIATED HEALTHCARE SYSTEMS OF RANDOLPH COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 MEDICAL CENTER DR
POCAHONTAS AR
72455-9436
US

IV. Provider business mailing address

2801 MEDICAL CENTER DR
POCAHONTAS AR
72455-9436
US

V. Phone/Fax

Practice location:
  • Phone: 870-892-6000
  • Fax: 870-892-6066
Mailing address:
  • Phone: 870-892-6000
  • Fax: 870-892-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License NumberAR4266
License Number StateAR

VIII. Authorized Official

Name: TERRY WHITTINGTON
Title or Position: C.E.O.
Credential:
Phone: 870-892-6000