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General NPI Number Information
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NPI Number | 1669668695
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Entity Type | Organization
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Legal Business Name | CITY OF POCAHONTAS AR
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 1505 N MARR ST
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City | POCAHONTAS
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State | AR
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Zip | 72455-2908
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Country | US
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Telephone | 870-892-6000
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Fax | 870-892-8100
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Provider Business Mailing Address
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Address Line | 1505 N MARR ST
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City | POCAHONTAS
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State | AR
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Zip | 72455-2908
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Country | US
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Telephone | 870-892-6000
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Fax | 870-892-8100
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Authorized Official
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Title or Position | ADMINISTRATOR / CEO
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Name | JOHN TUCKER
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Credential |
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Telephone | 870-892-6000
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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 |
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License Number State |
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