| Baxter Health Fulton County Hospital | |
|
673 N Main Street Ste A Salem AR 72576 | |
| (870) 895-4488 | |
| Not Available |
| Full Name | Baxter Health Fulton County Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 673 N Main Street, Salem, Arkansas |
| Authorized Official Name and Position | Debra Henry (CFO) |
| Authorized Official Contact | 8705081003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baxter Health Fulton County Hospital Po Box 517 Salem AR 72576-0517 Ph: (870) 895-2691 | Baxter Health Fulton County Hospital 673 N Main Street Ste A Salem AR 72576 Ph: (870) 895-4488 |
| NPI Number | 1336977172 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 10/28/2024 |
| Medicare PECOS PAC ID | 0749716876 |
|---|---|
| Medicare Enrollment ID | O20241216003520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336977172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Audrey Renee Crowl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487653242 PECOS PAC ID: 3870682057 Enrollment ID: I20110830000312 |
| Provider Name | Christopher Cochran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649359076 PECOS PAC ID: 5597893388 Enrollment ID: I20120626000197 |
| Provider Name | Tara Rae Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568293249 PECOS PAC ID: 2062943566 Enrollment ID: I20241008004140 |
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