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General NPI Number Information
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NPI Number | 1497956213
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Entity Type | Organization
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Legal Business Name | WASHINGTON REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 2863 N QUALITY LANE
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5521
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Country | US
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Telephone | 479-463-7384
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Fax | 479-442-2867
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Provider Business Mailing Address
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Address Line | 2863 N QUALITY LANE
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5521
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Country | US
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Telephone | 479-463-7384
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Fax | 479-442-2867
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Authorized Official
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Title or Position | SVP & CFO
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Name | MR. DAN R ECKELS
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Credential |
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Telephone | 479-463-6026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR4138
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License Number State | AR
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