Organization
ST BERNARD COMMUNITY HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN MATTES (ASSOCIATE ADMINISTRATOR)
(870) 238-3300
Entity
Organization
Contact information
Practice address
310 FALLS BLVD S, WYNNE, AR 72396-3013
(870) 238-3300
(870) 238-7432
Mailing address
310 FALLS BLVD S, WYNNE, AR 72396-3013
(870) 238-3300
(870) 238-7432
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
AR4063
AR
282NC0060X
Critical Access Hospital
AR4063
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1U025
ARKANSAS BLUE CROSS
AR
Enumeration date
08/10/2006
Last updated
09/17/2020
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