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General NPI Number Information
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NPI Number | 1366530883
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Entity Type | Organization
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Legal Business Name | CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 1321 WEST CHARLES BUSSEY AVE.
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City | LITTLE ROCK
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State | AR
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Zip | 72206
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Country | US
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Telephone | 501-374-3859
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 W CHARLES BUSSEY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1116
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Country | US
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Telephone | 501-374-3859
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Fax |
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Authorized Official
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Title or Position | DOMICILLARY CHIEF
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Name | LOUIS LEFEBVRE
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Credential | LCSW
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Telephone | 501-257-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 1766-M
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License Number State | AR
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