| Jefferson Comprehensive Care System, Inc | |
|
1724 Bishop St Little Rock AR 72202-6022 | |
| (870) 543-2300 | |
| Not Available |
| Full Name | Jefferson Comprehensive Care System, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1724 Bishop St, Little Rock, Arkansas |
| Authorized Official Name and Position | Sandra J. Brown (CEO) |
| Authorized Official Contact | 8705432380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Comprehensive Care System, Inc Po Box 1285 Pine Bluff AR 71613-1285 Ph: (870) 543-2300 | Jefferson Comprehensive Care System, Inc 1724 Bishop St Little Rock AR 72202-6022 Ph: (870) 543-2300 |
| NPI Number | 1457054769 |
|---|---|
| Provider Enumeration Date | 03/24/2023 |
| Last Update Date | 03/24/2023 |
| Medicare PECOS PAC ID | 5193634509 |
|---|---|
| Medicare Enrollment ID | O20230627001656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457054769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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