Provider Demographics
NPI:1093810392
Name:MENA HOSPITAL COMMISSION
Entity Type:Organization
Organization Name:MENA HOSPITAL COMMISSION
Other - Org Name:MENA REGIONAL HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR REVENUE CYLCE
Authorized Official - Prefix:
Authorized Official - First Name:GAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-243-2239
Mailing Address - Street 1:311 N MORROW
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-2516
Mailing Address - Country:US
Mailing Address - Phone:479-394-6100
Mailing Address - Fax:479-394-4577
Practice Address - Street 1:311 N MORROW
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2516
Practice Address - Country:US
Practice Address - Phone:479-394-6100
Practice Address - Fax:479-394-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4321163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10015OtherBLUE CROSS BLUE SHEILD
AR120522702Medicaid
57867Medicare PIN