Organization
BAXTER COUNTY REGIONAL HOSPITAL INC
Active
Other names
THE CLINIC AT WALMART OPERATED BY BAXTER REGIONAL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HENRY (CFO)
(870) 508-1003
Entity
Organization
Contact information
Practice address
65 WAL MART DR, MOUNTAIN HOME, AR 72653-6784
(870) 492-2200
Mailing address
PO BOX 2038, MOUNTAIN HOME, AR 72654-2038
(870) 492-2200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185021762
—
AR
01
—
DQ7079
RAILROAD MEDICARE
AR
Enumeration date
06/22/2010
Last updated
09/29/2016
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