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General NPI Number Information
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NPI Number | 1588632582
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Entity Type | Organization
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Legal Business Name | PHILLIPS HOSPITAL CORPORATION
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 1008 MAIN ST
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City | MARVELL
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State | AR
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Zip | 72366
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Country | US
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Telephone | 870-829-2521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 848092
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City | DALLAS
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State | TX
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Zip | 75284-8092
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LAURA HOLSFORD
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Credential |
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Telephone | 615-465-7466
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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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