Provider Demographics
NPI:1598773079
Name:ARKANSAS CHILDRENS HOSPITAL
Entity Type:Organization
Organization Name:ARKANSAS CHILDRENS HOSPITAL
Other - Org Name:ACH PHYSICIANS BILLING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AR CONTROL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-364-2526
Mailing Address - Street 1:PO BOX 959794
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-9794
Mailing Address - Country:US
Mailing Address - Phone:501-364-2526
Mailing Address - Fax:501-364-2438
Practice Address - Street 1:1 CHILDRENS WAY # 664
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-2526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR811282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR57113Medicare ID - Type Unspecified