Provider Demographics
NPI:1508294877
Name:MERCY HOSPITAL FORT SMITH
Entity Type:Organization
Organization Name:MERCY HOSPITAL FORT SMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-675-2800
Mailing Address - Street 1:880 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72927-3443
Mailing Address - Country:US
Mailing Address - Phone:479-675-2800
Mailing Address - Fax:
Practice Address - Street 1:880 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72927-3443
Practice Address - Country:US
Practice Address - Phone:479-675-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
047171Medicare Oscar/Certification