Organization
CHICOT MEMORIAL MEDICAL CENTER
Active
Other names
Chicot Memorial Medical center Women's Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN VAUGHN (CFO)
(870) 265-5351
Entity
Organization
Contact information
Practice address
2729 HWY 65 & 82 S, LAKE VILLAGE, AR 71653-6136
(870) 265-5351
(870) 265-2091
Mailing address
2729 HWY 65 & 82 S, LAKE VILLAGE, AR 71653-6136
(870) 265-5351
(870) 265-2091
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
AR4386
AR
282NC0060X
Critical Access Hospital
Primary
—
—
341600000X
Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181080105
—
AR
05
—
195528715
—
AR
Enumeration date
03/22/2010
Last updated
07/09/2015
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