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General NPI Number Information
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NPI Number | 1174588784
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Entity Type | Organization
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Legal Business Name | ST. MARY - ROGERS MEMORIAL HOSPITAL DBA FRIENDS HOUSE
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 W WALNUT ST
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City | ROGERS
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State | AR
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Zip | 72756-3546
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Country | US
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Telephone | 479-636-0200
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Fax | 479-986-3469
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Provider Business Mailing Address
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Address Line | 1200 W WALNUT ST
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City | ROGERS
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State | AR
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Zip | 72756-3546
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Country | US
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Telephone | 479-636-0200
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Fax | 479-986-3469
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. KENNETH C ROBINSON
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Credential |
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Telephone | 479-936-2843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 040
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License Number State | AR
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