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General NPI Number Information
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NPI Number | 1205936598
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Entity Type | Organization
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Legal Business Name | CENTRAL ARKANSAS VETRANS HEALTHCARE SERVICE
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 MOSSY CREEK DR
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4455
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Country | US
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Telephone | 501-225-6166
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Fax |
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Authorized Official
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Title or Position | PHARMACY SUPV
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Name | DR. WILLAIM F KEMP
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Credential | PD
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Telephone | 501-257-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 6066
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License Number State | AR
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