Provider Demographics
NPI:1699707539
Name:EUREKA SPRINGS HOSPITAL
Entity type:Organization
Organization Name:EUREKA SPRINGS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-253-7400
Mailing Address - Street 1:24 NORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3541
Mailing Address - Country:US
Mailing Address - Phone:479-253-7400
Mailing Address - Fax:479-363-8023
Practice Address - Street 1:24 NORRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-3541
Practice Address - Country:US
Practice Address - Phone:479-253-7400
Practice Address - Fax:479-363-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3896282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR=========OtherFEDERAL TAX ID
AR041304Medicare ID - Type UnspecifiedMEDICARE IP/OP
AR04Z304Medicare Oscar/Certification