| Jefferson Comprehensive Care System, Inc | |
|
113 W River Rd Redfield AR 72132 | |
| (501) 397-2261 | |
| (501) 397-2263 |
| Full Name | Jefferson Comprehensive Care System, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 W River Rd, Redfield, Arkansas |
| Authorized Official Name and Position | Larnell W Davis (EXECUTIVE DIRECTOR) |
| 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) 543-2380 | Jefferson Comprehensive Care System, Inc 113 W River Rd Redfield AR 72132 Ph: (501) 397-2261 |
| NPI Number | 1124224928 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 07/20/2007 |
| Medicare PECOS PAC ID | 5193634509 |
|---|---|
| Medicare Enrollment ID | O20100614000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124224928 | NPI | - | NPPES |
| 122635749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Phillips Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1011 Sheridan Road, Redfield, AR 72132 Phone: 501-397-2604 Fax: 501-397-2645 |