Provider Demographics
NPI:1720476005
Name:WHITE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:WHITE COUNTY MEDICAL CENTER
Other - Org Name:UNITY HEALTH PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-380-1004
Mailing Address - Street 1:1200 MCLAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-3534
Mailing Address - Country:US
Mailing Address - Phone:870-523-0190
Mailing Address - Fax:870-523-0188
Practice Address - Street 1:1200 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3534
Practice Address - Country:US
Practice Address - Phone:870-523-0190
Practice Address - Fax:870-523-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
040014Medicare Oscar/Certification