Provider Demographics
NPI:1932314879
Name:JOHN ED CHAMBERS MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:JOHN ED CHAMBERS MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-495-2241
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72833-0639
Mailing Address - Country:US
Mailing Address - Phone:479-495-2241
Mailing Address - Fax:479-495-6290
Practice Address - Street 1:719 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AR
Practice Address - Zip Code:72833-9607
Practice Address - Country:US
Practice Address - Phone:479-495-2241
Practice Address - Fax:479-495-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4293282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119267702Medicaid