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General NPI Number Information
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NPI Number | 1851443022
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Entity Type | Organization
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Legal Business Name | WASHINGTON REGIONAL MEDICORP, INC.
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 221 S SCHOOL AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5969
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Country | US
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Telephone | 479-442-5100
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Fax | 479-587-2679
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Provider Business Mailing Address
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Address Line | 221 S SCHOOL AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5969
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Country | US
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Telephone | 479-442-5100
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Fax | 479-587-2679
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JANE ELLEN LEDBETTER
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Credential |
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Telephone | 479-442-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 487
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License Number State | AR
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