Provider Demographics
NPI:1295862647
Name:ADVANCED CARE HOSPITAL OF WHITE COUNTY
Entity Type:Organization
Organization Name:ADVANCED CARE HOSPITAL OF WHITE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-278-3156
Mailing Address - Street 1:3214 EAST RACE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143
Mailing Address - Country:US
Mailing Address - Phone:501-278-3155
Mailing Address - Fax:501-278-3318
Practice Address - Street 1:3214 EAST RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143
Practice Address - Country:US
Practice Address - Phone:501-278-3155
Practice Address - Fax:501-278-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR282E00000X
ARAR4452282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10149OtherBCBS, TRUE BLUE PPO, FIRSTSOURCE PPO, HA HMO
AR042011Medicare Oscar/Certification
AR040149Medicare Oscar/Certification