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General NPI Number Information
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NPI Number | 1881489789
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Entity Type | Organization
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Legal Business Name | WHITE RIVER HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 501 VIRGINIA DR STE A
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City | BATESVILLE
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State | AR
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Zip | 72501-7317
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Country | US
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Telephone | 870-698-1846
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Fax | 870-793-2627
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Provider Business Mailing Address
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Address Line | 1710 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7303
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Country | US
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Telephone | 870-262-5545
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Fax | 870-262-6966
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | SHAWNA BAXTER
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Credential |
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Telephone | 870-262-5545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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