Provider Demographics
NPI:1386617934
Name:NATIONAL HEALTHCARE OF NEWPORT INC
Entity type:Organization
Organization Name:NATIONAL HEALTHCARE OF NEWPORT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7400
Mailing Address - Street 1:PO BOX 844790
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4790
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3533
Practice Address - Country:US
Practice Address - Phone:870-523-8911
Practice Address - Fax:870-523-0225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE OF NEWPORT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-13
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR698273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04S080Medicare Oscar/Certification