Provider Demographics
NPI:1033207675
Name:ADVANCE CARE HOSPITAL
Entity Type:Organization
Organization Name:ADVANCE CARE HOSPITAL
Other - Org Name:ADVANCE CARE HOSPITAL OF FORT SMITH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-277-2771
Mailing Address - Street 1:7301 ROGERS AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4100
Mailing Address - Country:US
Mailing Address - Phone:479-314-4900
Mailing Address - Fax:479-314-4980
Practice Address - Street 1:7301 ROGERS AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4100
Practice Address - Country:US
Practice Address - Phone:479-314-4900
Practice Address - Fax:479-314-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4139282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR3441098OtherAETNA PVN
AR186857105Medicaid
AR12008OtherBLUE CROSS BLUE SHIELD
AR7697536OtherAETNA PIN
042008Medicare Oscar/Certification