Organization
FULTON CO HOSPITAL HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HENRY (CFO)
(870) 508-1003
Entity
Organization
Contact information
Practice address
679 NO MAIN ST, SALEM, AR 72576
(870) 895-2273
(870) 895-6083
Mailing address
679 NO MAIN ST, P O BOX 517, SALEM, AR 72576
(870) 895-2273
(870) 895-6083
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
AR3873
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17115
BLUE CROSS PROVIDER NUMBE
AR
Enumeration date
01/10/2007
Last updated
02/06/2024
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