NPIMap

Organization Active NPI

Hospice of Southern Arkansas LLC

  • Community Based Hospice Care Agency
  • Pine Bluff, AR
National Provider Identifier
1841647997
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
AR5166 Issued in AR
Legal business name
HOSPICE OF SOUTHERN ARKANSAS LLC
Practice address
2620 W 28TH Ave
Pine Bluff, AR 71603-4917
Phone
(870) 536-8371
Fax
(870) 292-3841
NPI assigned
May 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Chris Lackner
Title
Delegated Official
Phone
(405) 412-4909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X AR5166 AR Primary

Addresses

Primary practice location

2620 W 28TH Ave
Pine Bluff, AR 71603-4917

Mailing address

5314 S Yale Ave
Suite 420
Tulsa, OK 74135-6256
Phone (405) 412-4909

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Southern Arkansas2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2620 W 28th Ave
Pine Bluff, AR 71603
Phone (870) 536-8371

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1841647997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5314 S YALE AVE",
            "address_2": "SUITE 420",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356256",
            "telephone_number": "405-412-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034917",
            "telephone_number": "870-536-8371",
            "fax_number": "870-292-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF SOUTHERN ARKANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "LACKNER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "405-412-4909"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AR",
            "license": "AR5166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.