Organization
NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION, INC
Active
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.
Other names
NEA Baptist Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST MEMORIAL HEALTH CARE CORP.
Authorized official
MR. GREGORY M. DUCKETT (SR. VP / CORPORATE SECRETARY)
(901) 227-5233
Entity
Organization
Contact information
Practice address
4802 E. JOHNSON AVENUE, JONESBORO, AR 72401
(870) 936-8000
Mailing address
350 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2177
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
MC-2122
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184473002
—
AR
01
—
5G237
BCBS
AR
Enumeration date
12/27/2013
Last updated
09/30/2020
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