Organization
DE QUEEN MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN E CAPSHEW (CEO)
(870) 584-4111
Entity
Organization
Contact information
Practice address
1306 W COLLIN RAYE DR, DE QUEEN, AR 71832
(870) 584-4111
(870) 584-4100
Mailing address
1306 W COLLIN RAYE DR, DE QUEEN, AR 71832-2502
(870) 584-4111
(870) 584-4100
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
AR4365
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157501002
—
AR
05
—
200064800A
—
OK
01
—
5F420
MEDICARE ID-ARKANSAS
AR
Enumeration date
09/05/2006
Last updated
08/27/2018
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