NORTH COMPLEX OUTPATIENT SURGERY CENTER (WHITE RIVER HEALTH SYSTEM, INC.) NPI 1215118492

Clinic/Center (Ambulatory Surgical) in Cherokee Village, AR

NPI 1215118492 Organization Clinic/Center Ambulatory Surgical

About NORTH COMPLEX OUTPATIENT SURGERY CENTER (WHITE RIVER HEALTH SYSTEM, INC.)

North Complex Outpatient Surgery Center (white River Health System,inc.) is a provider established in Cherokee Village, Arkansas specializing in clinic/center (ambulatory surgical) . The NPI number of North Complex Outpatient Surgery Center (white River Health System,inc.) is 1215118492 and was assigned on November 2007. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as North Complex Outpatient Surgery Center. The authorized official of this NPI record is Mr. Gary Bebow (Ceo)

NPI

1215118492

Provider NameNORTH COMPLEX OUTPATIENT SURGERY CENTER (WHITE RIVER HEALTH SYSTEM,INC.)
Provider Location Address197 HOSPITAL DR SUITE D CHEROKEE VILLAGE, AR 72529
Provider Mailing Address197 HOSPITAL DR SUITE D CHEROKEE VILLAGE, AR 72529
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameNORTH COMPLEX OUTPATIENT SURGERY CENTER
Other Name TypeDoing Business As (3)
Enumeration Date11-16-2007
Last Update Date07-08-2013


Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical

Business Address

NORTH COMPLEX OUTPATIENT SURGERY CENTER
197 HOSPITAL DR
SUITE D
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-6070
Fax: (870) 257-7667

Get Directions


Mailing Address

NORTH COMPLEX OUTPATIENT SURGERY CENTER
197 HOSPITAL DR
SUITE D
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-6061
Fax: (870) 257-7667



Authorized Official

Authorized Official NameMR. GARY BEBOW
Authorized Official TitleCEO
Authorized Official Phone(870) 262-6091

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
175016128MEDICAID (05)AR
AR4463OTHER (01)AR
15386OTHER (01)AR
11076OTHER (01)AR

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1114913936INTERNAL MEDICINE DIAGNOSTICS INC
Organization
Internal Medicine197 HOSPITAL DR SUITE B
CHEROKEE VILLAGE, AR 72529
(870) 257-5118
1508846015WHITE RIVER HEALTH SYSTEM, INC.
Organization
Clinic/Center (Primary Care)197 HOSPITAL DR
CHEROKEE VILLAGE, AR 72529
(870) 257-6070
1700845740 SURINDER P S SRA M.D.
Individual
Internal Medicine197 HOSPITAL DR SUITE B
CHEROKEE VLG, AR 72529
(870) 257-5118
1528022209MRS. JANET SUE TORBIT APN
Individual
Nurse Practitioner (Adult Health)197 HOSPITAL DR SUITE B
CHEROKEE VILLAGE, AR 72529
(870) 257-5118
1821423849WHITE RIVER HEALTH SYSTEM, INC.
Organization
Emergency Medicine197 HOSPITAL DR SUITE C
CHEROKEE VILLAGE, AR 72529
(870) 257-6070

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.