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:
Map and Directions
Authorized official contact:
Name: Coombe-Moore, Jackie Doctor of Medicine (MD)
Phone: (501) 505-8900

Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841513223 NPPES
Arkansas Other 11547000000 QCA
Arkansas Other 55779 QCA
Arkansas MEDICAID 122013001 QCA

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