Organization
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE ACKERSON (CEO)
(870) 448-5733
Entity
Organization
Contact information
Practice address
1103 WEST MAIN ST, GREEN FOREST, AR 72638-2810
(870) 438-6500
(870) 438-6615
Mailing address
PO BOX 1060, MARSHALL, AR 72650-1060
(870) 448-5101
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041876
MEDICARE OSCAR/ CERTIFICATION
AR
05
—
187063749
—
AR
01
—
5B477
BLUE CROSS
AR
Enumeration date
09/29/2009
Last updated
01/25/2019
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