Organization
DREW COUNTY MEMORIAL HOSPITAL
Active
Parent organization
DREW COUNTY MEMORIAL HOSPITAL
Other names
DREW MEMORIAL ANESTHESIA SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DREW COUNTY MEMORIAL HOSPITAL
Authorized official
SHANNON R CLARK (CFO)
(870) 460-3599
Entity
Organization
Contact information
Practice address
778 SCOGIN DRIVE, MONTICELLO, AR 71655-5729
(870) 367-2411
(952) 442-3620
Mailing address
400 EAST 10TH STREET, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159964002
—
AR
01
—
5F446
BLUE CROSS OF AR
AR
Enumeration date
05/26/2006
Last updated
10/25/2012
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