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General NPI Number Information
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NPI Number | 1194009019
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI COUNTY HOSPITAL SYSTEM
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 1520 N DIVISION ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-1448
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Country | US
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Telephone | 870-838-7460
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Fax | 870-838-7493
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Provider Business Mailing Address
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Address Line | 1520 N DIVISION ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-1448
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Country | US
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Telephone | 870-838-7460
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Fax | 870-838-7493
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Authorized Official
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Title or Position | COO/CNO
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Name | MR. CHRIS L RAYMER
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Credential | RN
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Telephone | 870-838-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | AR4562
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License Number State | AR
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