Provider Demographics
NPI:1386199057
Name:BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type:Organization
Organization Name:BAXTER COUNTY REGIONAL HOSPITAL, INC
Other - Org Name:BRMC SURGERY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RUDY
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:870-508-1002
Mailing Address - Street 1:230 HIGHWAY 5 N
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3027
Mailing Address - Country:US
Mailing Address - Phone:870-424-0517
Mailing Address - Fax:870-424-0514
Practice Address - Street 1:230 HIGHWAY 5 N
Practice Address - Street 2:SUITE 10
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3027
Practice Address - Country:US
Practice Address - Phone:870-424-0517
Practice Address - Fax:870-424-0514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAXTER COUNTY REGIONAL HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-23
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty