Organization
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELANIE CAMPBELL (EXECUTIVE DIRECTOR)
(870) 448-5101
Entity
Organization
Contact information
Practice address
110 VILLAGE VILLAGE PLACE, FAIRFIELD BAY, AR 72088
(501) 884-6898
(501) 884-6831
Mailing address
PO BOX 1060, MARSHALL, AR 72650-1060
(870) 448-5101
(870) 448-4769
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5B477
BLUE CROSS ARKANSAS GROUP
AR
Enumeration date
10/10/2006
Last updated
03/06/2008
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