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General NPI Number Information
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NPI Number | 1083849780
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Entity Type | Organization
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Legal Business Name | MENA HOSPITAL COMMISSION
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 311 MORROW ST N
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City | MENA
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State | AR
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Zip | 71953-2516
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Country | US
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Telephone | 870-385-2513
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Fax |
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Provider Business Mailing Address
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Address Line | 311 MORROW ST N
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City | MENA
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State | AR
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Zip | 71953-2516
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Country | US
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Telephone | 870-385-2513
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BOB ELLZEY
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Credential |
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Telephone | 479-394-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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