- Enrollment id
- O20070426000302
- Enrollment state
- AR
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1942237268
- Multiple npi flag
- N
- Ccn
- 047096
- Associate id
- 4688628167
- Organization name
- JOHN ED CHAMBERS MEMORIAL HOSPITAL INC
- Doing business as name
- CHAMBERS MEMORIAL HOSPITAL HOME HEALTH
- Incorporation date
- 1997-10-29
- Incorporation state
- AR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 719 DETROIT AVENUE
- City
- DANVILLE
- State
- AR
- Zip code
- 728330639