Provider Demographics
NPI:1497291520
Name:WHITE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:WHITE COUNTY MEDICAL CENTER
Other - Org Name:UNITY HEALTH LAB OF PATH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-203-2188
Mailing Address - Street 1:1915 W BEEBE CAPPS EXPY STE 100
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5012
Mailing Address - Country:US
Mailing Address - Phone:501-268-8175
Mailing Address - Fax:501-268-8337
Practice Address - Street 1:1915 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5012
Practice Address - Country:US
Practice Address - Phone:501-268-8175
Practice Address - Fax:501-268-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04D2122809OtherCLIA
AR218484002Medicaid