Provider Demographics
NPI:1548927429
Name:BAXTER COUNTY REGIONAL HOSPITAL, INC.
Entity type:Organization
Organization Name:BAXTER COUNTY REGIONAL HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PFS ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-508-1081
Mailing Address - Street 1:639 BROADMOOR CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2901
Mailing Address - Country:US
Mailing Address - Phone:870-508-6960
Mailing Address - Fax:870-508-6965
Practice Address - Street 1:639 BROADMOOR CIR STE 2
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2901
Practice Address - Country:US
Practice Address - Phone:870-508-6960
Practice Address - Fax:870-508-6965
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAXTER COUNTY REGIONAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty