JEFFERSON HOSPITAL ASSOCIATION, INC; NPI #1174542906

Contact Information

JEFFERSON HOSPITAL ASSOCIATION, INC

1601 W 40TH
SUITE 301
PINE BLUFF, AR 71603

Phone: 870-541-7220
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Cardiovascular Disease	207RC0000X	11	Physician/Internal Medicine

Indicates primary specialty

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NPI Profile & details for JEFFERSON HOSPITAL ASSOCIATION, INC

NPI Number 1174542906

LBN Legal business name JEFFERSON HOSPITAL ASSOCIATION, INC

Authorized official WALTER JOHNSON - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/19/2006

Last updated 03/18/2020 - About 6 years ago

Identifiers

AR	License #	E-4501
AR	Medicaid	163127002
AR	Other	5F630	BCBS
AR	Other	DF4052	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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