Healthcare Provider Details

I. General information

NPI: 1023042991
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 W OLD MAIN ST
YELLVILLE AR
72687-8284
US

IV. Provider business mailing address

PO BOX 718
YELLVILLE AR
72687-0718
US

V. Phone/Fax

Practice location:
  • Phone: 870-449-4221
  • Fax: 870-449-6777
Mailing address:
  • Phone: 870-449-4221
  • Fax: 870-449-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAR3827
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberAR3827
License Number StateAR

VIII. Authorized Official

Name: DEBRA HENRY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 870-508-1003