Provider Demographics
NPI:1972586238
Name:DEWITT HOSPITAL & NURSING HOME, INC.
Entity type:Organization
Organization Name:DEWITT HOSPITAL & NURSING HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM., CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-946-3571
Mailing Address - Street 1:1641 S WHITEHEAD DR
Mailing Address - Street 2:P.O. BOX 32
Mailing Address - City:DE WITT
Mailing Address - State:AR
Mailing Address - Zip Code:72042-2994
Mailing Address - Country:US
Mailing Address - Phone:870-946-3571
Mailing Address - Fax:870-946-4577
Practice Address - Street 1:1641 S WHITEHEAD DR
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-2994
Practice Address - Country:US
Practice Address - Phone:870-946-3571
Practice Address - Fax:870-946-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4093282NC0060X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR146780105Medicaid
AR146782715Medicaid
AR11314OtherAR BCBS
AR150147754Medicaid
AR146913002Medicaid
AR119692311Medicare Oscar/Certification
AR57237Medicare ID - Type UnspecifiedDR GROUP
AR045365Medicare Oscar/Certification
AR11314OtherAR BCBS
AR146913002Medicaid