MEDICARE: MERCY HOSPITAL FORT SMITH

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1841717519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HOSPITAL FORT SMITH

Provider Business Mailing Address
First Line	:	7301 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4100
Country	:	US
Telephone Number	:	479-314-7530
Fax Number	:	479-314-7531

Provider Business Practice Location Address
First Line	:	5401 ELLSWORTH RD
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3219
Country	:	US
Telephone Number	:	479-314-7530
Fax Number	:	479-314-7531

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	GRETA LYNN WILCHER
Credential	:
Telephone Number	:	479-314-6100

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	08/24/2017

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Directions to “MERCY HOSPITAL FORT SMITH ” Practice Location

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