Provider Demographics
NPI:1376596569
Name:WOMENS CENTER OF NORTHWEST ARKANSAS LLC
Entity Type:Organization
Organization Name:WOMENS CENTER OF NORTHWEST ARKANSAS LLC
Other - Org Name:WILLOW CREEK WOMEN'S HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-473-7000
Mailing Address - Street 1:PO BOX 841278
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1278
Mailing Address - Country:US
Mailing Address - Phone:479-684-3000
Mailing Address - Fax:479-684-3075
Practice Address - Street 1:4301 GREATHOUSE RD.
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72741
Practice Address - Country:US
Practice Address - Phone:479-684-3000
Practice Address - Fax:479-684-3075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3904282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
04-0141Medicare Oscar/Certification