Provider Demographics
NPI:1508877697
Name:PIGGOTT COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:PIGGOTT COMMUNITY HOSPITAL
Other - Org Name:HOMECARE MEDICAL EQUIPMENT & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-3881
Mailing Address - Street 1:1206 GORDON DUCKWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-1911
Mailing Address - Country:US
Mailing Address - Phone:870-598-3881
Mailing Address - Fax:870-598-5915
Practice Address - Street 1:210 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PIGGOTT
Practice Address - State:AR
Practice Address - Zip Code:72454-2725
Practice Address - Country:US
Practice Address - Phone:870-598-3881
Practice Address - Fax:870-598-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00327332BX2000X
MO9947332BX2000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO621359900Medicaid
AR113743716Medicaid
AR49399OtherBC/BS