Provider Demographics
NPI:1033124839
Name:ASSOCIATED HEALTHCARE SYSTEMS OF RANDOLPH COUNTY
Entity Type:Organization
Organization Name:ASSOCIATED HEALTHCARE SYSTEMS OF RANDOLPH COUNTY
Other - Org Name:RANDOLPH COUNTY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:COVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-892-6000
Mailing Address - Street 1:2801 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-9436
Mailing Address - Country:US
Mailing Address - Phone:870-892-6000
Mailing Address - Fax:890-892-6066
Practice Address - Street 1:2801 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-9436
Practice Address - Country:US
Practice Address - Phone:870-892-6000
Practice Address - Fax:890-892-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4266282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10047OtherAR BLUE CROSS PROVIDER #
AR04U047Medicare Oscar/Certification
AR10047OtherAR BLUE CROSS PROVIDER #
AR040047Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER