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General NPI Number Information
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NPI Number | 1295774917
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Entity Type | Organization
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Legal Business Name | MERCY HOSPITAL WALDRON
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 100 N WALNUT AVE STE A
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City | MANSFIELD
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State | AR
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Zip | 72944-3522
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Country | US
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Telephone | 479-928-4404
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Fax | 479-928-4414
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Provider Business Mailing Address
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Address Line | 5401 ELLSWORTH RD
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City | FORT SMITH
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State | AR
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Zip | 72903-3219
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Country | US
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Telephone | 479-314-1101
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Fax | 479-314-4740
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Authorized Official
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Title or Position | VP FINANCE MERCY CAH
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Name | SHERRY LYNN CLOUSE DAY
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Credential |
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Telephone | 417-820-8439
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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 | AR4196
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License Number State | AR
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