Organization · Type 2 NPI

Jefferson Comprehensive Care System, Inc

Federally Qualified Health Center (FQHC) · Altheimer, AR

NPI number 1730385105 Active

Practice location

309 S Edline
Altheimer, AR 72004-8559

Call (870) 766-8411 Map

Fax (870) 766-8412

Mailing address

PO Box 1285
Pine Bluff, AR 71613-1285

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

NPI record

NPI: 1730385105
Entity type: Organization (Type 2)
Issued: Jun 22, 2007
Last updated: Jul 20, 2007
Status: Active
Subpart: Yes of Jefferson Comprehensive Care System, Inc

Other names

<unavail>
Altheimer Center · doing business as

Authorized official

Mr. Larnell W Davis
Executive Director
(870) 543-2380

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1730385105

Jefferson Comprehensive Care System, Inc's National Provider Identifier is 1730385105, issued on Jun 22, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Altheimer, AR. The record was last updated on Jul 20, 2007.