Provider Demographics
NPI:1952526311
Name:MARION COUNTY HEALTHCARE ASSN
Entity Type:Organization
Organization Name:MARION COUNTY HEALTHCARE ASSN
Other - Org Name:MARION COUNTY NURSING HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEARMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-449-4201
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:YELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72687-0309
Mailing Address - Country:US
Mailing Address - Phone:870-449-4201
Mailing Address - Fax:870-449-6695
Practice Address - Street 1:620 N. PANTHER ST
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687-0620
Practice Address - Country:US
Practice Address - Phone:870-449-4201
Practice Address - Fax:870-449-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR193314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility