Provider Demographics
NPI:1255717914
Name:EUREKA SPRINGS HOSPITAL FAMILY CLINIC LLC
Entity type:Organization
Organization Name:EUREKA SPRINGS HOSPITAL FAMILY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-253-7400
Mailing Address - Street 1:24 NORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3541
Mailing Address - Country:US
Mailing Address - Phone:479-253-7400
Mailing Address - Fax:
Practice Address - Street 1:4052 E VAN BUREN
Practice Address - Street 2:SUITE A
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-9499
Practice Address - Country:US
Practice Address - Phone:479-253-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EUREKA SPRINGS HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty