MEDICARE: EUREKA SPRINGS HOSPITAL COMMISSION

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
1	261QC0050X	Critical Access Hospital Clinic/Center

General Provider Information

NPI Number	:	1275104226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUREKA SPRINGS HOSPITAL COMMISSION

Provider Business Mailing Address
First Line	:	24 NORRIS ST
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-3541
Country	:	US
Telephone Number	:	479-253-7400
Fax Number	:	479-363-8017

Provider Business Practice Location Address
First Line	:	25 NORRIS ST
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-3508
Country	:	US
Telephone Number	:	479-253-1300
Fax Number	:	479-363-8017

Authorized Official
Title or Position	:	HR DIRECTOR
Name	:	JODI EDMONDSON
Credential	:
Telephone Number	:	479-253-7400

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	07/09/2021

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