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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 Specialty Code Provider Type

Oncology

261QX0200X
Indicates primary specialty

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

NPI # 1912328428
LBN Legal business name NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Authorized official GREGORY DUCKETT - (SR. VP / CORPORATE SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 12/31/2013
Last updated 09/29/2020 - About 6 years ago
Identifiers
AR Medicaid 184473002
AR Other 5G237 BCBS
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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