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JEFFERSON HOSPITAL ASSOCIATION INC NPI 1841235868


NPI Information

NPI: 1841235868
Provider Name: JEFFERSON HOSPITAL ASSOCIATION, INC

Doing Business As: JEFFERSON REGIONAL HEALTHWORKS

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 04D0698656

Address:
4201 S MULBERRY ST STE A
PINE BLUFF, AR
ZIP 71603
Phone: (870) 536-6600
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JEFFERSON HOSPITAL ASSOCIATION, INC is a clinic center in Pine Bluff, AR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). JEFFERSON HOSPITAL ASSOCIATION, INC NPI is 1841235868. The provider is registered as an organization entity type.
The provider Is Doing Business As Jefferson Regional Healthworks.

The provider's business location address is:

4201 S MULBERRY ST STE A
PINE BLUFF, AR
ZIP 71603-002
Phone: (870) 536-6600
Fax: (870) 534-1519

The provider's authorized official is Bryan Jackson .
The authorized official title is Vp/chief Admin Officer and has the following contact phone number (870) 541-7141.

The CLIA number assigned to this NPI record is 04D0698656 - industrial with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2006 and was last updated on 4/12/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
156802OTHERARKANSASBLUE CROSS BLUE SHIELD
2CI2242OTHERARKANSASRAILROAD MEDICARE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.