Organization
ST BERNARD COMMUNITY HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN SCOTT MATTES (ASSOCIATE ADMINISTRATOR)
(870) 208-2145
Entity
Organization
Contact information
Practice address
310 FALLS BLVD S, WYNNE, AR 72396-3013
(870) 238-3300
(870) 238-7432
Mailing address
PO BOX 590, WYNNE, AR 72396-0590
(870) 238-3300
(870) 238-7432
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
AR4063
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145193002
—
AR
01
—
56847
BLUE CROSS PROF FEES
AR
Enumeration date
08/09/2006
Last updated
09/17/2020
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