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Organization

SGOH ACQUISITION INC

Active
Other names
OZARKS COMMUNITY HOSPITAL OF GRAVETTE
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL GREGORY TAYLOR (ADMINISTRATOR/CEO)
(417) 837-2000
Entity
Organization

Contact information

Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
(479) 344-6404
Mailing address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5291
(417) 832-9041

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
AR4517
AR
213E00000X
Podiatrist
AR4517
AR
261Q00000X
Clinic/Center
261QC0050X
Critical Access Hospital Clinic/Center
AR4517
AR
282NC0060X
Critical Access Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568643005
MO
05
168370105
AR
05
200200390A
OK
Enumeration date
11/26/2007
Last updated
07/16/2024
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