SGOH ACQUISITION INC NPI 1568643005

NPI Information

NPI: 1568643005
Provider Name: SGOH ACQUISITION INC

Doing Business As: OZARKS COMMUNITY HOSPITAL OF GRAVETTE

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
1101 JACKSON ST SW
GRAVETTE, AR
ZIP 72736
Phone: (417) 837-4000
Get Directions

SGOH ACQUISITION INC is a critical access general acute care hospital in Gravette, AR. The provider is definition to come. SGOH ACQUISITION INC NPI is 1568643005. The provider is registered as an organization entity type.
The provider Is Doing Business As Ozarks Community Hospital Of Gravette.

The provider's business location address is:

1101 JACKSON ST SW
GRAVETTE, AR
ZIP 72736-121
Phone: (417) 837-4000
Fax: (417) 875-4791

The provider's authorized official is Paul Gregory Taylor .
The authorized official title is Administrator/ceo and has the following contact phone number (417) 837-4090.

The CLIA number assigned to this NPI record is 04D1081363 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/26/2007 and was last updated on 10/25/2019.

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	261QC0050X	Clinic/Center	Critical Access Hospital	AR4517	ARKANSAS	No
2	103T00000X	Psychologist		AR4517	ARKANSAS	No
3	213E00000X	Podiatrist		AR4517	ARKANSAS	No
4	261Q00000X	Clinic/Center				No
5	282NC0060X	General Acute Care Hospital	Critical Access			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1568643005	MEDICAID	MISSOURI
2	200200390A	MEDICAID	OKLAHOMA
3	168370105	MEDICAID	ARKANSAS

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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