MEDICARE: BAXTER COUNTY REGIONAL 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
1	207Q00000X	Family Medicine Physician
2	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1316745144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAXTER COUNTY REGIONAL HOSPITAL, INC

Provider Business Mailing Address
First Line	:	103 MOUNTAIN PLACE DR
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-6802
Country	:	US
Telephone Number	:	870-269-3447
Fax Number	:	870-269-3448

Provider Business Practice Location Address
First Line	:	103 MOUNTAIN PLACE DR
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-6802
Country	:	US
Telephone Number	:	870-269-3447
Fax Number	:	870-269-3448

Authorized Official
Title or Position	:	CFO
Name	:	DEBRA HENRY
Credential	:
Telephone Number	:	870-508-1003

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	05/26/2026

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