Organization
RUSSELLVILLE HOLDINGS LLC
Active
Parent organization
RUSSELLVILLE HOLDINGS LLC
Other names
Valley Health Services of Hector
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSSELLVILLE HOLDINGS LLC
Authorized official
TERRANCE DILLON (ASSISTANT SECRETARY)
(502) 596-7220
Entity
Organization
Contact information
Practice address
11720 SR 27, HECTOR, AR 72843-8712
(479) 284-5001
(479) 284-4210
Mailing address
11720 SR 27, HECTOR, AR 72843-8712
(479) 968-2841
(479) 968-8189
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
4192
AR
363LF0000X
Family Nurse Practitioner
A001233
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182331729
—
AR
Enumeration date
05/14/2006
Last updated
04/11/2022
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