Provider Demographics
NPI:1639366461
Name:EUREKA SPINGS HOSPITAL LLC
Entity Type:Organization
Organization Name:EUREKA SPINGS HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-253-7400
Mailing Address - Street 1:24 NORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3541
Mailing Address - Country:US
Mailing Address - Phone:479-253-7400
Mailing Address - Fax:479-363-8017
Practice Address - Street 1:24 NORRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-3541
Practice Address - Country:US
Practice Address - Phone:318-226-8202
Practice Address - Fax:318-226-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR041304Medicare Oscar/Certification