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Contact Information

JEFFERSON COMPREHENSIVE CARE SYSTEM, INC
113 W RIVER RD
REDFIELD, AR72132
 Phone: 501-397-2261
 Fax: 501-397-2263
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for JEFFERSON COMPREHENSIVE CARE SYSTEM, INC

NPI Number 1124224928
LBN Legal business name JEFFERSON COMPREHENSIVE CARE SYSTEM, INC
Authorized official LARNELL DAVIS - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/27/2007
Last updated 07/20/2007 - About 19 years ago
Identifiers
AR Medicaid 122635749
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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