1962698993 NPI number — THE PUBLIC BUILDING AUTHORITY OF THE CITY OF POCAHONTAS ARKANSAS

NPI Number: 1962698993
Health Care Provider/Practitioner: THE PUBLIC BUILDING AUTHORITY OF THE CITY OF POCAHONTAS ARKANSAS

NPI Number : 1962698993 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962698993",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "THE PUBLIC BUILDING AUTHORITY OF THE CITY OF POCAHONTAS ARKANSAS",
    "ParentOrgTIN": null,
    "OrgName": "THE PUBLIC BUILDING AUTHORITY OF THE CITY OF POCAHONTAS ARKANSAS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "504 TEXAS ST STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SHREVEPORT",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "71101-3526",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "318-226-8202",
    "MailingAddressFaxNumber": "318-226-8205",
    "FirstLinePracticeLocationAddress": "2801 MEDICAL CENTER DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "POCAHONTAS",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72455-9436",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "318-226-8202",
    "PracticeLocationAddressFaxNumber": "318-226-8205",
    "EnumerationDate": "09/24/2007",
    "LastUpdateDate": "12/13/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BORDELON",
    "AuthorizedOfficialFirstName": "ROCK",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "318-226-8202",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "275N00000X",
        "TaxonomyName": "Medicare Defined Swing Bed Hospital Unit",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}