JEFFERSON COMPREHENSIVE CARE SYSTEM INC NPI 1194922849

NPI Information

NPI: 1194922849
Provider Name: JEFFERSON COMPREHENSIVE CARE SYSTEM, INC

Doing Business As: LITTLE ROCK COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1100 N UNIVERSITY AVE
SUITE 125
LITTLE ROCK, AR
ZIP 72207
Phone: (501) 663-0055
Get Directions

JEFFERSON COMPREHENSIVE CARE SYSTEM, INC is a federally qualified health center (fqhc) clinic center in Little Rock, AR. JEFFERSON COMPREHENSIVE CARE SYSTEM, INC NPI is 1194922849. The provider is registered as an organization entity type.
The provider Is Doing Business As Little Rock Community Health Center.

The provider's business location address is:

1100 N UNIVERSITY AVE
SUITE 125
LITTLE ROCK, AR
ZIP 72207-343
Phone: (501) 663-0055

The provider's authorized official is Chanda Evans-mcfield .
The authorized official title is Cfo and has the following contact phone number (870) 536-5525.

The CLIA number assigned to this NPI record is 04D0999477 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/27/2007 and was last updated on 10/3/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	041851	MEDICARE OSCAR/CERTIFICATION	ARKANSAS
2	150090749	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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