Provider Demographics
NPI:1922261890
Name:FULTON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:FULTON COUNTY HOSPITAL
Other - Org Name:NORTH ARKANSAS FAMILY 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:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AR
Mailing Address - Zip Code:72576
Mailing Address - Country:US
Mailing Address - Phone:870-895-2152
Mailing Address - Fax:
Practice Address - Street 1:673 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AR
Practice Address - Zip Code:72576
Practice Address - Country:US
Practice Address - Phone:870-895-4488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FULTON COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-09
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center