; NPI #1104506799

Contact Information

JAVITS L JACKSON

8 WHITE TAIL CV
PINE BLUFF, AR 71603-8149

Phone: 870-718-1186
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Taxi	344600000X

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NPI Profile & details for

NPI #	`1104506799`
Entity	Organization
Organization subpart ¹	Not specified
Enumeration date	07/19/2023
Last updated	07/19/2023 - 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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