Organization · Type 2 NPI

Jefferson Comprehensive Care System, Inc

Federally Qualified Health Center (FQHC) · College Station, AR

NPI number 1932305737 Active

Practice location

4206 Frazier Pike
College Station, AR 72053

Call (501) 490-2440 Map

Fax (501) 490-0156

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...

Another provider at this address

Jefferson Comprehensive Care System, Inc.General Practice Dentistry College Station, AR NPI 1073886156

NPI record

NPI: 1932305737
Entity type: Organization (Type 2)
Issued: Jun 27, 2007
Last updated: Jul 20, 2007
Status: Active
Subpart: Yes of Jefferson Comprehensive Care System, Inc

Other names

<unavail>
College Station Center · doing business as

Authorized official

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

Verify this record

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 1932305737

Jefferson Comprehensive Care System, Inc's National Provider Identifier is 1932305737, issued on Jun 27, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in College Station, AR. The record was last updated on Jul 20, 2007.