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NPI Code Detail

MEDICARE: ST BERNARDS HOSPITAL INC

MEDICARE: ST BERNARDS 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/CenterAR4053AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112303OTHERARBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134141906
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST BERNARDS HOSPITAL INC
Provider Business Mailing Address
First Line : 225 E WASHINGTON AVE
Second Line :
City : JONESBORO
State : AR
Zip : 72401-3111
Country : US
Telephone Number : 870-972-4470
Fax Number : 870-974-5084
Provider Business Practice Location Address
First Line : 225 E WASHINGTON AVE
Second Line :
City : JONESBORO
State : AR
Zip : 72401-3111
Country : US
Telephone Number : 870-972-4470
Fax Number : 870-974-5084
Authorized Official
Title or Position : CFO
Name : MR. BENJAMIN BARYLSKE
Credential :
Telephone Number : 870-972-4565
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/20/2020

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Directions to “ST BERNARDS HOSPITAL INC ” Practice Location

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