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
HC 31 BOX 310, DEER, AR 72628
(870) 428-5391
(870) 428-5392
Mailing address
PO BOX 1060, MARSHALL, AR 72650-1060
(870) 448-5101
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150794749
—
AR
01
—
5B477
BLUE CROSS AR
AR
01
—
DA1111
RAILROAD MEDICARE GROUP
AR
Enumeration date
10/10/2006
Last updated
01/25/2019
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