NPI: 1710934542
Provider Name: JEFFERSON SURGERY CENTER PLLC
Former Legal Business Name: JHA AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization
Specialization: Ambulatory Surgical
Address:
1609 W 40TH AVE
JRMC PROFESSIONAL CENTER, SUITE 103
PINE BLUFF, AR
ZIP 71603
Phone: (870) 541-3636
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JEFFERSON SURGERY CENTER PLLC is an ambulatory surgical clinic center in Pine Bluff, AR. JEFFERSON SURGERY CENTER PLLC NPI is 1710934542. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Jha Ambulatory Surgery Center, Llc.
The provider's business location address is:
1609 W 40TH AVE
JRMC PROFESSIONAL CENTER, SUITE 103
PINE BLUFF, AR
ZIP 71603-329
Phone: (870) 541-3636
Fax: (870) 541-3639
The provider's authorized official is Crystal R Bohannan .
The authorized official title is Administrator and has the following contact phone number (870) 541-3640.
The enumeration date for this NPI number is 5/27/2006 and was last updated on 8/26/2008.