ARKANSAS RENAL SYSTEMS INC. NPI 1720079692

NPI Information

NPI: 1720079692
Provider Name: ARKANSAS RENAL SYSTEMS, INC.

Doing Business As: JACKSONVILLE DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
202 JOHN HARDEN DR
JACKSONVILLE, AR
ZIP 72076
Phone: (501) 982-2224
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ARKANSAS RENAL SYSTEMS, INC. is an end-stage renal disease (esrd) treatment clinic center in Jacksonville, AR. ARKANSAS RENAL SYSTEMS, INC. NPI is 1720079692. The provider is registered as an organization entity type.
The provider Is Doing Business As Jacksonville Dialysis Center.

The provider's business location address is:

202 JOHN HARDEN DR
JACKSONVILLE, AR
ZIP 72076-775
Phone: (501) 982-2224
Fax: (501) 982-4220

The provider's authorized official is William Stanley .
The authorized official title is Ceo and has the following contact phone number (501) 663-0490.

The enumeration date for this NPI number is 10/31/2005 and was last updated on 6/11/2008.

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	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			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	12535	OTHER	ARKANSAS	BLUE CROSS BLUE SHIELD
2	126820134	MEDICAID	ARKANSAS
3	042535	MEDICARE OSCAR/CERTIFICATION	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

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