Provider Demographics
NPI:1528360989
Name:FIVE RIVERS MEDICAL CENTER INC.
Entity type:Organization
Organization Name:FIVE RIVERS MEDICAL CENTER INC.
Other - Org Name:<UNAVAIL>
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:870-892-8100
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:870-892-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR040047Medicare Oscar/Certification