Organization
GREAT RIVER MEDICAL CENTER LLC
Active
Organization
GREAT RIVER MEDICAL CENTER LLC
Active
Parent organization
GREAT RIVER MEDICAL CENTER LLC
Other names
Great River Anesthesia Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT RIVER MEDICAL CENTER LLC
Authorized official
LACEY CARTER (CEO)
(870) 838-7460
Entity
Organization
Contact information
Practice address
1520 N DIVISION ST, BLYTHEVILLE, AR 72315-1448
(870) 838-7300
Mailing address
PO BOX 108, BLYTHEVILLE, AR 72316-0108
(870) 838-7300
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/03/2026
Last updated
08/10/2026
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