Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC.
Active
Other names
NEA Baptist Clinic Dialysis Center/Hilltop
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY M DUCKETT (SR VP/ CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
4909 EAST JOHNSON AVE., JONESBORO, AR 72401
(870) 336-3372
(870) 934-3658
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
(901) 227-5233
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12577
BCBS
AR
05
—
200341134
—
AR
Enumeration date
09/12/2011
Last updated
09/30/2020
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