Provider Demographics
NPI:1164779989
Name:BRIM HOLDING COMPANY, INC.
Entity Type:Organization
Organization Name:BRIM HOLDING COMPANY, INC.
Other - Org Name:WADLEY REGIONAL MEDICAL CENTER AT HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-722-3800
Mailing Address - Street 1:2001 S MAIN ST
Mailing Address - Street 2:ATTN: BILLING
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8124
Mailing Address - Country:US
Mailing Address - Phone:870-722-3800
Mailing Address - Fax:903-798-8030
Practice Address - Street 1:2001 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8124
Practice Address - Country:US
Practice Address - Phone:870-722-3804
Practice Address - Fax:870-722-3840
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIM HOLDING COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-10
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04S153Medicare Oscar/Certification