# NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NEA Baptist Mobile Health Unit
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417721689
- **Authorized official:** MR. GREGORY M DUCKETT SR. VP/CLO (SR VP/CHIEF LEGAL OFFICER)
- **Authorized official phone:** (901) 227-5233

## Contact information

- **Practice address:** 4800 E JOHNSON AVE, JONESBORO, AR 72405-8413
- **Practice address phone:** (870) 936-8000
- **Mailing address:** 350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
- **Mailing address phone:** (901) 227-5233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR0207X | Mobile Mammography Clinic/Center | — | NULL | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 11/08/2023
- **Last updated:** 11/08/2023