Provider Demographics
NPI:1891781837
Name:PIGGOTT COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:PIGGOTT COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-3881
Mailing Address - Street 1:1206 GORDON DUCKWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-1911
Mailing Address - Country:US
Mailing Address - Phone:870-598-3881
Mailing Address - Fax:870-598-2480
Practice Address - Street 1:1206 GORDON DUCKWORTH DR
Practice Address - Street 2:
Practice Address - City:PIGGOTT
Practice Address - State:AR
Practice Address - Zip Code:72454-1911
Practice Address - Country:US
Practice Address - Phone:870-598-3881
Practice Address - Fax:870-598-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3149282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101505105Medicaid
AR101518715Medicaid
MO011359908Medicaid
AR041330Medicare Oscar/Certification