MEDICARE: REGENCY HOSPITAL OF NORTHWEST ARKANSAS, LLC

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	282E00000X	Long Term Care Hospital	AR4182	AR

Other Identifiers

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

General Provider Information

NPI Number	:	1689676272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENCY HOSPITAL OF NORTHWEST ARKANSAS, LLC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DPT
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	609 W MAPLE AVE
Second Line	:	6TH FLOOR
City	:	SPRINGDALE
State	:	AR
Zip	:	72764-5335
Country	:	US
Telephone Number	:	479-757-2670
Fax Number	:	479-757-2677

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. JOHN DUGGAN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	09/10/2025

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