Healthcare Provider Details

I. General information

NPI: 1043268451
Provider Name (Legal Business Name): MERCY HOSPITAL WALDRON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 W 6TH ST
WALDRON AR
72958-7642
US

IV. Provider business mailing address

5401 ELLSWORTH RD
FORT SMITH AR
72903-3219
US

V. Phone/Fax

Practice location:
  • Phone: 479-637-2136
  • Fax: 479-637-5411
Mailing address:
  • Phone: 479-314-1101
  • Fax: 479-314-4704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERRY LYNN CLOUSE DAY
Title or Position: VP FINANCE MERCY CAH
Credential:
Phone: 417-820-8439