Provider Demographics
NPI:1003916420
Name:EUREKA SPRINGS HOSPITAL
Entity Type:Organization
Organization Name:EUREKA SPRINGS HOSPITAL
Other - Org Name:EUREKA SPRINGS HOSPITAL HOME HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:479-253-7400
Mailing Address - Street 1:24 NORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3541
Mailing Address - Country:US
Mailing Address - Phone:479-253-7400
Mailing Address - Fax:479-363-8017
Practice Address - Street 1:6 FOREST PARK
Practice Address - Street 2:SUITE D & E
Practice Address - City:HOLIDAY ISLAND
Practice Address - State:AR
Practice Address - Zip Code:72631
Practice Address - Country:US
Practice Address - Phone:479-253-5554
Practice Address - Fax:479-253-7708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4253251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04-7134Medicare ID - Type UnspecifiedHOME HEALTH