Healthcare Provider Details

I. General information

NPI: 1699836775
Provider Name (Legal Business Name): CRITTENDEN HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 11/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W TYLER AVE
WEST MEMPHIS AR
72301-4223
US

IV. Provider business mailing address

PO BOX 2248
WEST MEMPHIS AR
72303-2248
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-1500
  • Fax: 870-732-7714
Mailing address:
  • Phone: 870-735-1500
  • Fax: 870-732-7714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number2986
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2986
License Number StateAR

VIII. Authorized Official

Name: MS. DANA SMITH
Title or Position: PATIENT FINANCIAL SERVICES DIRECTOR
Credential:
Phone: 870-735-1500