Provider Demographics
NPI:1710541289
Name:BAXTER COUNTY REGIONAL HOSPITAL INC
Entity Type:Organization
Organization Name:BAXTER COUNTY REGIONAL HOSPITAL INC
Other - Org Name:BAXTER HEALTH PHYSICAL THERAPY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-508-1003
Mailing Address - Street 1:740 BUTTERCUP DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2960
Mailing Address - Country:US
Mailing Address - Phone:870-508-6976
Mailing Address - Fax:870-508-1615
Practice Address - Street 1:414 W OLD MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687-8284
Practice Address - Country:US
Practice Address - Phone:870-449-7456
Practice Address - Fax:870-449-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy