MERCY HOSPITAL WALDRON NPI 1295774917

NPI Information

NPI: 1295774917
Provider Name: MERCY HOSPITAL WALDRON

Other Name: MERCY FAMILY MEDICINE - MANSFIELD

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

Specialization: Rural Health

Address:
100 N WALNUT AVE STE A
MANSFIELD, AR
ZIP 72944
Phone: (479) 928-4404
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MERCY HOSPITAL WALDRON is a rural health clinic center in Mansfield, AR. MERCY HOSPITAL WALDRON NPI is 1295774917. The provider is registered as an organization entity type.
The provider Other Name Is Mercy Family Medicine - Mansfield.

The provider's business location address is:

100 N WALNUT AVE STE A
MANSFIELD, AR
ZIP 72944-522
Phone: (479) 928-4404
Fax: (479) 928-4414

The provider's authorized official is Sherry Lynn Clouse Day .
The authorized official title is Vp Finance Mercy Cah and has the following contact phone number (417) 820-8439.

The CLIA number assigned to this NPI record is 04D0881080 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 2/17/2021.

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	AR4196	ARKANSAS	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	162620729	MEDICAID	ARKANSAS
2	5F644	OTHER	ARKANSAS	BLUE CROSS BLUESHIELD

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

NPI Synchronization or Removal

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