Provider Demographics
NPI:1871555185
Name:PIGGOTT COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:PIGGOTT COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-3881
Mailing Address - Street 1:1206 GORDON DUCKWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-1911
Mailing Address - Country:US
Mailing Address - Phone:870-598-3881
Mailing Address - Fax:870-598-5716
Practice Address - Street 1:1206 GORDON DUCKWORTH DR
Practice Address - Street 2:
Practice Address - City:PIGGOTT
Practice Address - State:AR
Practice Address - Zip Code:72454-1911
Practice Address - Country:US
Practice Address - Phone:870-598-3881
Practice Address - Fax:870-598-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4319207PE0004X, 207Q00000X, 207RC0000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO505459701Medicaid
AR101529002Medicaid