Provider Demographics
NPI:1841469194
Name:WHITE COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:WHITE COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, TREASURER
Authorized Official - Prefix:MR
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 1:3014 E MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4822
Mailing Address - Country:US
Mailing Address - Phone:501-268-4169
Mailing Address - Fax:501-268-2349
Practice Address - Street 1:3014 E MOORE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4822
Practice Address - Country:US
Practice Address - Phone:501-268-4169
Practice Address - Fax:501-268-2349
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE COUNTY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-20
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR016310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility