South East Arkansas Lab & SCR SVCS

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

04D1059019 Issued in AR

Legal business name

SOUTH EAST ARKANSAS LAB & SCR SVCS

Practice address

201 S Main St
Pine Bluff, AR 71601

Phone

(870) 534-6699

NPI assigned

Jul 30, 2007

Last updated

Feb 23, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTH EAST ARK. LABORATORY & SCR SVCSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert A. Rosen, BS PD

Title

President

Phone

(870) 534-6699

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Southeast Arkansas Labratory SCNV

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1649460379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71601",
            "telephone_number": "870-534-6699",
            "fax_number": "870-534-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71601",
            "telephone_number": "870-534-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EAST ARKANSAS LAB & SCR SVCS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH EAST ARK. LABORATORY & SCR SVCS",
        "enumeration_date": "2007-07-30",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-534-6699",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS PD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "04D1059019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164955709",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Arkansas Hematology & Oncology Clinic PA
• South Arkansas Nephrology and Hypertension Clinic
• South Arkansas Orthopaedic Center
• South Arkansas Pathology, PLLC
• South Arkansas Surgical Associates
• Southeast Arkansas Behavioral Healthcare System Inc
• Southeast Arkansas Behavioral Healthcare System, Inc
• Southeast Arkansas Emergency Physicians LLP
• Southeast Arkansas Emergency Physicians LLP
• Southeast Arkansas Hospice LTD Co

• Clinical Medical Laboratory in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Clinical Medical Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.