JEFFERSON REGIONAL MEDICAL CENTER (NPI# 1851421861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851421861 |
| Entity Type | Organization |
| Organization Name | JEFFERSON REGIONAL MEDICAL CENTER |
| Practice Address |
1600 W 40th Ave Pine Bluff AR 71603-6301 |
| Practice Telephone | 8705417100 |
| Practice Fax Number | 8705417499 |
| Mailing Telephone | 8705417100 |
| Mailing Fax Number | 8705417499 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | MR. BRIAN THOMAS (PRESIDENT & CEO) |
| Authorized Official Telephone | 8705417214 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
AR05666 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | IP PHARM DEA NUMBER | AJ3219664 | 01 |
| AR | OP PHARM DEA NUMBER | AJ6766630 | 01 |
| AR | 100339407 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720056138 | Jefferson Regional Medical Center | Psychiatry & Neurology | 810 Clairton Blvd Ste 500600, Pittsburgh, PA 15236-5505 | 2006-03-10 |
| 1578560504 | Jefferson Regional Medical Center | General Acute Care Hospital | 565 Coal Valley Rd, Clairton, PA 15025-3703 | 2005-07-06 |
| 1316481989 | Jefferson Regional Medical Center | Pharmacy | 565 Coal Valley Rd, Jefferson Hills, PA 15025-3703 | 2016-12-15 |
| 1962748913 | Jefferson Regional Medical Center | General Acute Care Hospital | 575 Coal Valley Rd, Suite 574, Jefferson Hills, PA 15025-3730 | 2012-12-19 |
| 1467531038 | Jefferson Regional Medical Center | General Acute Care Hospital | 565 Coal Valley Rd, Pittsburgh, PA 15236 | 2006-11-03 |
| 1821104753 | Jefferson Regional Medical Center | General Acute Care Hospital | 565 Coal Valley Road, Pittsburgh, PA 15236-0119 | 2006-08-22 |
| 1366488108 | Jefferson Regional Medical Center | General Acute Care Hospital | 565 Coal Valley Rd, Clairton, PA 15025-3703 | 2006-06-21 |
| 1013985126 | Jefferson Regional Medical Center | Rehabilitation Unit | 565 Coal Valley Rd, Clairton, PA 15025-3703 | 2006-03-14 |
| 1336117787 | Jefferson Regional Medical Center | General Acute Care Hospital | 565 Coal Valley Rd, Clairton, PA 15025-3703 | 2006-03-10 |
| 1891763249 | Jefferson Regional Medical Center | Counselor | 810 Clairton Blvd Ste 500600, Pittsburgh, PA 15236-5505 | 2006-03-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JEFFERSON REGIONAL MEDICAL CENTER | 1400 Us Hwy 61, Festus, MO 63028-4100 |
| Street Address |
1600 W 40TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-6301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033172317 | Rebekah A Crowder | Dietitian, Registered | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2006-04-08 |
| 1164044509 | Shelly R Caine | Registered Nurse | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2020-05-08 |
| 1447870415 | Lakita Davis | Nurse Practitioner | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2020-04-20 |
| 1730739715 | Robert Benjamin Noble | Physician Assistant | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-09-12 |
| 1932757382 | Sarah Victoria Brown | Dietitian, Registered | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-08-29 |
| 1669020012 | Haley Nicole Shrell | Dietitian, Registered | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-08-29 |
| 1467000810 | Michael Carlton Turley | Dietitian, Registered | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-08-29 |
| 1639727084 | Laura Elizabeth Drinkwater | Dietitian, Registered | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-08-29 |
| 1316501901 | April Summer Mcghee | Nurse Practitioner | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-04-29 |
| 1609339365 | Andy Diaz | Physical Therapy Assistant | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 2019-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942358874 | Supermarket Investors Inc | Pharmacy | 2901 Olive Street, Pine Bluff, AR 71601 | 2007-01-08 |
| 1528463775 | Wpm Community Pharmacies, LLC | Pharmacy | 3006 W 28th Ave, Pine Bluff, AR 71603-4803 | 2014-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1215557905 | Medman23, Inc | Pharmacy | 3201 Springhill Dr Ste 110, North Little Rock, AR 72117-2910 | 2020-04-22 |
| 1336768985 | Harps Food Stores, Inc | Pharmacy | 611 Highway 62 65 N, Harrison, AR 72601-2208 | 2020-04-14 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on JEFFERSON REGIONAL MEDICAL CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.