Arkansas Renal Systems, Inc.
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jacksonville, AR
NPI 1720079692 · NPPES record last updated Jun 11, 2008
Key facts
- NPI
- 1720079692
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- ARKANSAS RENAL SYSTEMS, INC.
- Practice address
- 202 John Harden Dr
Jacksonville, AR 72076-3775 - Phone
- (501) 982-2224
- Fax
- (501) 982-4220
- NPI assigned
- Oct 31, 2005
- Organization subpart
- No
Authorized official
- Name
- William Stanley
- Title
- Ceo
- Phone
- (501) 663-0490
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
202 John Harden Dr
Jacksonville, AR 72076-3775
Mailing address
PO Box 17930
Little Rock, AR 72222-7930
Phone (501) 663-0490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126820134 | Medicaid | AR | |
| 12535 | Other | AR | BLUE CROSS BLUE SHIELD |
Other names
- Jacksonville Dialysis Center
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All providers in Jacksonville, AR · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.