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General NPI Number Information
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NPI Number | 1881635993
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Entity Type | Organization
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Legal Business Name | IZARD COUNTY MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 61 GRASSE ST
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City | CALICO ROCK
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State | AR
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Zip | 72519-0438
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Country | US
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Telephone | 870-297-3726
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Fax | 870-297-4161
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Provider Business Mailing Address
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Address Line | PO BOX 438
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City | CALICO ROCK
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State | AR
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Zip | 72519-0438
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Country | US
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Telephone | 870-297-3726
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Fax | 870-297-4161
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. KIM SKIDMORE
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Credential | CEO
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Telephone | 870-297-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | AR3931
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | AR3931
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License Number State | AR
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