Conway Psychiatric Center
LBN: Jackie Coombe-Moore Pa
Conway Psychiatric Center is an health care organization with primary practice located at 680 Hogan Ln , Conway AR 72034-8131. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty.
Jackie Coombe-Moore Pa can be contacted via phone (501) 505-8900, or through Coombe-Moore, Jackie via phone (501) 505-8900.
Contact Information
Primary practice address
680 Hogan Ln
Conway AR 72034-8131
Phone: (501) 505-8900
Fax: (501) 505-8902
Website:
Authorized official contact:
Name: Coombe-Moore, Jackie Doctor of Medicine (MD)
Phone: (501) 505-8900
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X |
Profile Details
NPI number | 1841513223 |
---|---|
LBN Legal business name | Jackie Coombe-Moore Pa |
DBA Doing business as | Conway Psychiatric Center |
Authorized official | Coombe-Moore, Jackie Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Mar 12th, 2010 |
Last updated | Mar 26th, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841513223 | NPPES |
Arkansas | Other | 11547000000 | QCA |
Arkansas | Other | 55779 | QCA |
Arkansas | MEDICAID | 122013001 | QCA |
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