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General NPI Number Information
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NPI Number | 1013941806
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Entity Type | Organization
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Legal Business Name | BOONEVILLE COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 880 W. MAIN ST.
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City | BOONEVILLE
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State | AR
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Zip | 72927
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Country | US
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Telephone | 479-675-2800
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Fax | 479-675-2881
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Provider Business Mailing Address
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Address Line | 880 W. MAIN STREET P.O. BOX 290
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City | BOONEVILLE
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State | AR
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Zip | 72927
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Country | US
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Telephone | 479-675-2800
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Fax | 479-675-2881
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Authorized Official
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Title or Position | CFO
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Name | MR. ROBIN CALVIN ROBERTSON
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Credential |
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Telephone | 479-675-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | AR4154
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License Number State | AR
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