Provider Demographics
NPI:1598322810
Name:MENA HOSPITAL COMMISSION
Entity Type:Organization
Organization Name:MENA HOSPITAL COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUEBEDEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-243-2237
Mailing Address - Street 1:311 MORROW ST N
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-2516
Mailing Address - Country:US
Mailing Address - Phone:479-243-2130
Mailing Address - Fax:479-394-4577
Practice Address - Street 1:1103 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2519
Practice Address - Country:US
Practice Address - Phone:479-394-1414
Practice Address - Fax:877-775-6761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty