Organization
SOUTHWEST ARKANSAS HEALTHCARE, LLC
Active
Other names
Tri-Lakes Medical Center ER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT R HICKS (CEO)
(870) 285-3182
Entity
Organization
Contact information
Practice address
315 EAST 13TH STREET, MURFREESBORO, AR 71958-0000
(870) 285-3182
(870) 285-3305
Mailing address
PO BOX F, MURFREESBORO, AR 71958-0000
(870) 285-3182
(870) 285-3305
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
82
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158153002
—
AR
01
—
5F344
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
07/07/2006
Last updated
01/22/2010
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