Provider Demographics
NPI:1154770436
Name:WHITE RIVER HEALTH SYSTEM, INC.
Entity type:Organization
Organization Name:WHITE RIVER HEALTH SYSTEM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAXSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-262-1960
Mailing Address - Street 1:1215 SIDNEY ST
Mailing Address - Street 2:STE 300
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7203
Mailing Address - Country:US
Mailing Address - Phone:870-793-1126
Mailing Address - Fax:870-793-1180
Practice Address - Street 1:1215 SIDNEY ST
Practice Address - Street 2:STE 300
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7203
Practice Address - Country:US
Practice Address - Phone:870-793-1126
Practice Address - Fax:870-793-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty