Provider Demographics
NPI:1073616462
Name:PIKE COUNTY MEMORIAL HOSPITAL-SB
Entity Type:Organization
Organization Name:PIKE COUNTY MEMORIAL HOSPITAL-SB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-285-3182
Mailing Address - Street 1:PO BOX F
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:71958-1005
Mailing Address - Country:US
Mailing Address - Phone:870-285-3182
Mailing Address - Fax:870-285-3305
Practice Address - Street 1:315 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:AR
Practice Address - Zip Code:71958-9541
Practice Address - Country:US
Practice Address - Phone:870-285-3182
Practice Address - Fax:870-285-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR82275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10081OtherBCBS ID #
AR04U081Medicare ID - Type UnspecifiedMEDICARE ID