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General NPI Number Information
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NPI Number | 1962698993
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Entity Type | Organization
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Legal Business Name | THE PUBLIC BUILDING AUTHORITY OF THE CITY OF POCAHONTAS ARKANSAS
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 2801 MEDICAL CENTER DR
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City | POCAHONTAS
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State | AR
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Zip | 72455-9436
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Country | US
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Telephone | 318-226-8202
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Fax | 318-226-8205
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Provider Business Mailing Address
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Address Line | 504 TEXAS ST STE 200
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City | SHREVEPORT
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State | LA
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Zip | 71101-3526
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Country | US
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Telephone | 318-226-8202
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Fax | 318-226-8205
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Authorized Official
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Title or Position | CEO
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Name | MR. ROCK BORDELON
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Credential |
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Telephone | 318-226-8202
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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 |
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License Number State |
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