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DREW COUNTY MEMORIAL HOSPITAL NPI 1124074430


NPI Information

NPI: 1124074430
Provider Name: DREW COUNTY MEMORIAL HOSPITAL

Doing Business As: DREW MEMORIAL ANESTHESIA SERVICES

Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Organization

CLIA Number: 04D0678168

Address:
778 SCOGIN DRIVE
MONTICELLO, AR
ZIP 71655
Phone: (870) 367-2411
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DREW COUNTY MEMORIAL HOSPITAL is a nurse anesthetist certified registered in Monticello, AR. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. DREW COUNTY MEMORIAL HOSPITAL NPI is 1124074430. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Drew Memorial Anesthesia Services.

The provider's business location address is:

778 SCOGIN DRIVE
MONTICELLO, AR
ZIP 71655-729
Phone: (870) 367-2411
Fax: (952) 442-3620

The provider's authorized official is Shannon R Clark .
The authorized official title is Cfo and has the following contact phone number (870) 460-3599.

The CLIA number assigned to this NPI record is 04D0678168 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 10/25/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified RegisteredYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1159964002MEDICAIDARKANSAS
25F446MEDICARE ID-TYPE UNSPECIFIEDARKANSAS
35F446OTHERARKANSASBLUE CROSS OF AR

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: 4/28/2024

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