Provider Demographics
NPI:1346301306
Name:ST. BERNARDS MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. BERNARDS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARYLSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-207-4565
Mailing Address - Street 1:2712 E JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-1874
Mailing Address - Country:US
Mailing Address - Phone:870-932-2800
Mailing Address - Fax:870-932-1189
Practice Address - Street 1:2712 E JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-1874
Practice Address - Country:US
Practice Address - Phone:870-932-2800
Practice Address - Fax:870-932-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4053282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital