Provider Demographics
NPI:1477958106
Name:MCGEHEE HOSPITAL INCORPORATED
Entity type:Organization
Organization Name:MCGEHEE HOSPITAL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:AMSTUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-690-4132
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:MC GEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654-0707
Mailing Address - Country:US
Mailing Address - Phone:870-222-6131
Mailing Address - Fax:870-222-5909
Practice Address - Street 1:1507 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MC GEHEE
Practice Address - State:AR
Practice Address - Zip Code:71654
Practice Address - Country:US
Practice Address - Phone:870-222-6131
Practice Address - Fax:870-222-5909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4657261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR207179729Medicaid
AR18509OtherBLUE CROSS