Provider Demographics
NPI:1205936598
Name:CENTRAL ARKANSAS VETRANS HEALTHCARE SERVICE
Entity type:Organization
Organization Name:CENTRAL ARKANSAS VETRANS HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY SUPV
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:F
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:501-257-6333
Mailing Address - Street 1:3016 MOSSY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4455
Mailing Address - Country:US
Mailing Address - Phone:501-225-6166
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6066282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access