Healthcare Provider Details

I. General information

NPI: 1770805459
Provider Name (Legal Business Name): JAMESTOWN HEALTH AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 02/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S HAMPTON PL
ROGERS AR
72758-1352
US

IV. Provider business mailing address

299 S 24TH ST
ROGERS AR
72758-1102
US

V. Phone/Fax

Practice location:
  • Phone: 479-986-8431
  • Fax: 479-636-1184
Mailing address:
  • Phone: 479-636-5497
  • Fax: 479-621-9095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID L NORSWORTHY
Title or Position: CHEIF OPERATING OFFICER
Credential:
Phone: 479-636-5497