Provider Demographics
NPI:1841717519
Name:MERCY HOSPITAL FORT SMITH
Entity type:Organization
Organization Name:MERCY HOSPITAL FORT SMITH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-314-6100
Mailing Address - Street 1:7301 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4100
Mailing Address - Country:US
Mailing Address - Phone:479-314-7530
Mailing Address - Fax:479-314-7531
Practice Address - Street 1:5401 ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3219
Practice Address - Country:US
Practice Address - Phone:479-314-7530
Practice Address - Fax:479-314-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies