National Provider Identifier Database

NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION INC
Oncology

An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents.


Contact Information

NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
4808 E JOHNSON AVE
JONESBORO, AR72401-8413
Phone: 870-936-8000
Fax: 870-932-3608
Website:
Specialty Taxonomy Code
* Oncology 261QX0200X

* Indicates primary specialty

NPI Profile & details for NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.

NPI Number 1912328428
Legal business name
LBN
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Authorized official GREGORY DUCKETT - (SR. VP / CORPORATE SECRETARY)
Entity Organization
Organization subpart No
Enumeration date 12/31/2013
Last updated 09/29/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AR Medicaid: 184473002
  • AR Other: 5G237 BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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