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NPI Code Detail

MEDICARE: JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.

MEDICARE: JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073748406
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN ED CHAMBERS MEMORIAL HOSPITAL, INC.
Provider Business Mailing Address
First Line : PO BOX 639
Second Line :
City : DANVILLE
State : AR
Zip : 72833-0639
Country : US
Telephone Number : 479-495-2241
Fax Number : 479-495-6290
Provider Business Practice Location Address
First Line : 719 DETROIT AVE
Second Line :
City : DANVILLE
State : AR
Zip : 72833-9607
Country : US
Telephone Number : 479-495-2241
Fax Number : 479-495-6223
Authorized Official
Title or Position : CFO
Name : PAULA MICHAELLE CORNWELL
Credential :
Telephone Number : 479-495-2241
Provider Enumeration Date : 05/29/2009
Last Update Date : 01/12/2024

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