CROSSETT HEALTH FOUNDATION NPI 1093084808

NPI Information

NPI: 1093084808
Provider Name: CROSSETT HEALTH FOUNDATION

Doing Business As: HAMBURG HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
319 W PARKER ST
HAMBURG, AR
ZIP 71646
Phone: (870) 853-8271
Get Directions

CROSSETT HEALTH FOUNDATION is a rural health clinic center in Hamburg, AR. CROSSETT HEALTH FOUNDATION NPI is 1093084808. The provider is registered as an organization entity type.
The provider Is Doing Business As Hamburg Health Clinic.

The provider's business location address is:

319 W PARKER ST
HAMBURG, AR
ZIP 71646-121
Phone: (870) 853-8271
Fax: (870) 364-1245

The provider's authorized official is Phillip K Gilmore .
The authorized official title is Ceo and has the following contact phone number (870) 364-1271.

The CLIA number assigned to this NPI record is 04D0924524 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2011 and was last updated on 4/9/2013.

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	048501	MEDICARE UPIN	ARKANSAS
2	54255	OTHER	ARKANSAS	BLUE CROSS
3	163845729	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: 5/5/2024

NPI Synchronization or Removal

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