Provider Demographics
NPI:1417798893
Name:FIVE RIVERS MEDICAL CENTER INC.
Entity type:Organization
Organization Name:FIVE RIVERS MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:BARYMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-892-6200
Mailing Address - Street 1:2801 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-9436
Mailing Address - Country:US
Mailing Address - Phone:870-892-6000
Mailing Address - Fax:870-892-6258
Practice Address - Street 1:2801 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-9436
Practice Address - Country:US
Practice Address - Phone:870-892-6000
Practice Address - Fax:870-892-6258
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIVE RIVERS MEDICAL CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty