Basic Information
| Provider Information | |||||||||
| NPI: | 1245409663 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAPTIST MEDICAL CENTER HEBER SPRINGS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11001 EXECUTIVE CENTER DR | ||||||||
| Address2: | STE 200 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114316 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 BYPASS ROAD | ||||||||
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| City: | HEBER SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018873000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2008 | ||||||||
| LastUpdateDate: | 05/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | CAMBRON | ||||||||
| AuthorizedOfficialFirstName: | TERELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | TEAM LEAD ER PATIENT ACCTS | ||||||||
| AuthorizedOfficialTelephone: | 5018127751 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 142056002 | 05 | AR | MEDICAID |