NPIMap

Organization Active NPI

Southwest Arkansas Healthcare, LLC

Doing business as Tri-Lakes Medical Center ER

  • Contractor
  • Murfreesboro, AR
National Provider Identifier
1275565491
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
82 Issued in AR
Legal business name
SOUTHWEST ARKANSAS HEALTHCARE, LLC
Doing business as
Tri-Lakes Medical Center ER
Practice address
315 East 13TH Street
Murfreesboro, AR 71958-0000
Phone
(870) 285-3182
Fax
(870) 285-3305
NPI assigned
Jul 7, 2006
Last updated
Jan 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Authorized official

Name
Mr. Robert R Hicks
Title
Ceo
Phone
(870) 285-3182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 82 AR Primary

Addresses

Primary practice location

315 East 13TH Street
Murfreesboro, AR 71958-0000

Mailing address

PO Box F
Murfreesboro, AR 71958-0000
Phone (870) 285-3182

Other identifiers 2

IdentifierTypeStateIssuer
158153002MedicaidAR
5F344OtherARBLUE CROSS & BLUE SHIELD

Other names 1

  • Tri-Lakes Medical Center ER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Generations of Hope Geriatric Psychiatry Unit5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1275565491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX F",
            "city": "MURFREESBORO",
            "state": "AR",
            "postal_code": "719580000",
            "telephone_number": "870-285-3182",
            "fax_number": "870-285-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 EAST 13TH STREET",
            "city": "MURFREESBORO",
            "state": "AR",
            "postal_code": "719580000",
            "telephone_number": "870-285-3182",
            "fax_number": "870-285-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ARKANSAS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-285-3182",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AR",
            "license": "82",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158153002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "5F344",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Lakes Medical Center ER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murfreesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.