NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.; NPI #1417721689

Contact Information

NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.

4800 E JOHNSON AVE
JONESBORO, AR 72405-8413

Phone: 870-936-8000
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Radiology, Mobile Mammography	261QR0207X	45	Mammography Center
Health Service	261QH0100X
Medical	363AM0700X	97	Physician Assistant
Multi-Specialty	261QM1300X	70	Clinic or Group Practice
Primary Care	261QP2300X

Indicates primary specialty

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

NPI Number	`1417721689`
LBN Legal business name	NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Authorized official	GREGORY DUCKETT - (SR VP/CHIEF LEGAL OFFICER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	11/08/2023
Last updated	11/08/2023 - About 3 years ago
Identifiers	n/a

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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