Provider Demographics
NPI:1629150537
Name:DREW MEMORIAL HOSPITAL PERSONAL CARE
Entity Type:Organization
Organization Name:DREW MEMORIAL HOSPITAL PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HH AND PC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:870-367-1154
Mailing Address - Street 1:778 SCOGIN DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-5729
Mailing Address - Country:US
Mailing Address - Phone:870-367-1154
Mailing Address - Fax:870-460-3534
Practice Address - Street 1:778 SCOGIN DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-5729
Practice Address - Country:US
Practice Address - Phone:870-367-1154
Practice Address - Fax:870-460-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3421282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural