DIERKSEN OF TEXARKANA ARKANSAS LLC NPI 1104088632

NPI Information

NPI: 1104088632
Provider Name: DIERKSEN OF TEXARKANA ARKANSAS LLC

Doing Business As: DIERKSEN MEMORIAL HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 04D2199772

Address:
4613 PARKWAY DR STE 20
TEXARKANA, AR
ZIP 71854
Phone: (870) 773-4353
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DIERKSEN OF TEXARKANA ARKANSAS LLC is a hospice care community based in Texarkana, AR. DIERKSEN OF TEXARKANA ARKANSAS LLC NPI is 1104088632. The provider is registered as an organization entity type.
The provider Is Doing Business As Dierksen Memorial Hospice.

The provider's business location address is:

4613 PARKWAY DR STE 20
TEXARKANA, AR
ZIP 71854
Phone: (870) 773-4353

The provider's authorized official is John Hunter .
The authorized official title is President & Ceo and has the following contact phone number (434) 977-9711.

The CLIA number assigned to this NPI record is 04D2199772 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2008 and was last updated on 1/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		AR 4279	ARKANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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