Healthcare Provider Details

I. General information

NPI: 1194843730
Provider Name (Legal Business Name): BRADLEY COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 S BRADLEY ST
WARREN AR
71671-3459
US

IV. Provider business mailing address

404 S BRADLEY ST
WARREN AR
71671-3459
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-3731
  • Fax: 870-226-4300
Mailing address:
  • Phone: 870-226-3731
  • Fax: 870-226-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LESLIE HUITT
Title or Position: CEO/CFO
Credential:
Phone: 870-226-3731