Provider Demographics
NPI:1023381738
Name:ST. VINCENT INFIRMARY MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. VINCENT INFIRMARY MEDICAL CENTER
Other - Org Name:ST. VINCENT HEART CLINIC ARKANSAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-552-3571
Mailing Address - Street 1:10100 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6202
Mailing Address - Country:US
Mailing Address - Phone:501-225-6000
Mailing Address - Fax:501-255-6400
Practice Address - Street 1:10100 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6202
Practice Address - Country:US
Practice Address - Phone:501-225-6000
Practice Address - Fax:501-255-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty