Drew County Memorial Hospital

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

DREW COUNTY MEMORIAL HOSPITAL

Doing business as

Drew Memorial Anesthesia Services

Practice address

778 Scogin Drive
Monticello, AR 71655-5729

Phone

(870) 367-2411

Fax

(952) 442-3620

NPI assigned

May 26, 2006

Last updated

Oct 25, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

DREW COUNTY MEMORIAL HOSPITALAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon R Clark

Title

Cfo

Phone

(870) 460-3599

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DREW MEMORIAL ANESTHESIA SERVICES Doing business as

Part of

Drew Memorial Emergency

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1124074430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST 10TH STREET",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 SCOGIN DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555729",
            "telephone_number": "870-367-2411",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREW COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DREW COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-460-3599"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159964002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AR",
            "identifier": "5F446",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DREW MEMORIAL ANESTHESIA SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracie Doshier
• Dr. James L. Price, Jr. (James L Price, Jr)
• Dr. Ricky Ferguson Vision Center PA
• Drew Central School District
• Drew County Memorial Hospital
• Drew County Memorial Hospital
• Drew County Memorial Hospital
• Drew County Memorial Hospital (Drew Memorial Hospital Home Health Agency)
• Drew County Memorial Hospital
• Drew Memorial Hospital HDM

• Certified Registered Nurse Anesthetist in Monticello, AR
• Providers in Monticello, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.