Organization
BOARD OF GOVERNORS OF DALLAS COUNTY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH E SANDERS (ADMINISTRATION / CEO)
(870) 352-6363
Entity
Organization
Contact information
Practice address
201 N CLIFTON ST, FORDYCE, AR 71742-3026
(870) 352-6363
Mailing address
201 N CLIFTON ST, FORDYCE, AR 71742-3026
(870) 352-6363
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z317
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/24/2008
Last updated
05/18/2017
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