Provider Demographics
NPI:1184828188
Name:CHI ST VINCENT HOSPITAL HOT SPRINGS
Entity Type:Organization
Organization Name:CHI ST VINCENT HOSPITAL HOT SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TADD
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-522-3912
Mailing Address - Street 1:PO BOX 29001
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-9001
Mailing Address - Country:US
Mailing Address - Phone:501-622-4565
Mailing Address - Fax:501-622-1199
Practice Address - Street 1:300 WERNER ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6406
Practice Address - Country:US
Practice Address - Phone:501-622-4565
Practice Address - Fax:501-622-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4058261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR770032305Medicaid