Provider Demographics
NPI:1417398678
Name:WHITE RIVER HEALTH SYSTEM, INC
Entity Type:Organization
Organization Name:WHITE RIVER HEALTH SYSTEM, INC
Other - Org Name:BATESVILLE ORTHOPAEDIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEBOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-262-6091
Mailing Address - Street 1:501 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7331
Mailing Address - Country:US
Mailing Address - Phone:870-793-2371
Mailing Address - Fax:870-793-7585
Practice Address - Street 1:501 VIRGINIA DR
Practice Address - Street 2:SUITE C
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7331
Practice Address - Country:US
Practice Address - Phone:870-793-2371
Practice Address - Fax:870-793-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty