CHICOT MEMORIAL MEDICAL CENTER NPI 1003213281

NPI Information

NPI: 1003213281
Provider Name: CHICOT MEMORIAL MEDICAL CENTER
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
2729 HWY 65 & 82 S
LAKE VILLAGE, AR
ZIP 71653
Phone: (870) 265-5351
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CHICOT MEMORIAL MEDICAL CENTER is a rural health clinic center in Lake Village, AR. CHICOT MEMORIAL MEDICAL CENTER NPI is 1003213281. The provider is registered as an organization entity type.

The provider's business location address is:

2729 HWY 65 & 82 S
LAKE VILLAGE, AR
ZIP 71653-136
Phone: (870) 265-5351
Fax: (870) 265-2091

The provider's authorized official is Susan Vaughn .
The authorized official title is Cfo and has the following contact phone number (870) 265-5351.

The enumeration date for this NPI number is 12/3/2014 and was last updated on 4/13/2018.

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	261QR1300X	Clinic/Center	Rural Health			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	Other Provider Identifier Issuer
1	04-1328	OTHER		MEDICARE PROVIDER NUMBER
2	181080105	MEDICAID	ARKANSAS
3	04-Z328	OTHER		MEDICARE PROVIDER NUMBER

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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