Provider Demographics
NPI:1275603060
Name:ARKANSAS METHODIST HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:ARKANSAS METHODIST HOSPITAL CORPORATION
Other - Org Name:AMMC HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR REVENUE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-239-7126
Mailing Address - Street 1:900 W KINGSHIGHWAY
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5942
Mailing Address - Country:US
Mailing Address - Phone:870-239-7152
Mailing Address - Fax:
Practice Address - Street 1:900 W KINGSHIGHWAY
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5942
Practice Address - Country:US
Practice Address - Phone:870-239-7152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4057251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134872754Medicaid
AR134358752Medicaid
AR134586765Medicaid
AR17004OtherBLUE CROSS
AR133775732Medicaid
AR102531514Medicaid
AR047004Medicare PIN