Organization
CROSSETT HEALTH FOUNDATION
Active
Parent organization
CROSSETT HEALTH FOUNDATION
Other names
Hamburg Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSETT HEALTH FOUNDATION
Authorized official
MR. PHILLIP K GILMORE (CEO)
(870) 364-1271
Entity
Organization
Contact information
Practice address
319 W PARKER ST, HAMBURG, AR 71646-3121
(870) 853-8271
(870) 364-1245
Mailing address
319 W PARKER ST, HAMBURG, AR 71646-3121
(870) 853-8271
(870) 364-1245
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163845729
—
AR
01
—
54255
BLUE CROSS
AR
Enumeration date
12/22/2011
Last updated
04/09/2013
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