Provider Demographics
NPI:1851343834
Name:CHI ST VINCENT HOSPITAL HOT SPRINGS
Entity Type:Organization
Organization Name:CHI ST VINCENT HOSPITAL HOT SPRINGS
Other - Org Name:MERCY HOME HEALTH CORNERSTONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TADD
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-552-3912
Mailing Address - Street 1:PO BOX 20040
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-318-6800
Mailing Address - Fax:501-318-6855
Practice Address - Street 1:220 MCAULEY CT
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6312
Practice Address - Country:US
Practice Address - Phone:501-318-6800
Practice Address - Fax:501-318-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4944251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102376514Medicaid
AR102376514Medicaid