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General NPI Number Information
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NPI Number | 1972313237
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Entity Type | Organization
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Legal Business Name | BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 403 POLK ST
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City | HUNTSVILLE
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State | AR
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Zip | 72740-9130
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Country | US
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Telephone | 479-738-1583
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Fax | 479-738-1350
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Provider Business Mailing Address
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Address Line | PO BOX 1060
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City | MARSHALL
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State | AR
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Zip | 72650-1060
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Country | US
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Telephone | 870-448-5101
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Fax | 870-448-3767
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Authorized Official
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Title or Position | CEO
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Name | DEBBIE ACKERSON
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Credential |
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Telephone | 870-448-5733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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