Organization
BOSTON MOUNTAIN RURAL HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE ACKERSON (CEO)
(870) 448-5733
Entity
Organization
Contact information
Practice address
2263 HIGHWAY 65 NORTH, MARSHALL, AR 72650-1060
(870) 448-5733
(870) 448-4769
Mailing address
PO BOX 1060, MARSHALL, AR 72650-1060
(870) 448-5733
(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
05
—
124795749
—
AR
05
—
133965749
—
AR
05
—
135037749
—
AR
05
—
149029749
—
AR
05
—
150794749
—
AR
01
—
5B477
BLUE CROSS
AR
01
—
DA1111
RAILROAD MEDICARE GROUP
AR
Enumeration date
08/03/2006
Last updated
01/25/2019
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