Provider Demographics
NPI:1275958290
Name:JEWELL CAPITAL PLLC
Entity Type:Organization
Organization Name:JEWELL CAPITAL PLLC
Other - Org Name:NORTH CENTRAL IV & RESPIRATORY SPECIALSITS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-932-0150
Mailing Address - Street 1:202 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3102
Mailing Address - Country:US
Mailing Address - Phone:870-932-0150
Mailing Address - Fax:870-932-0870
Practice Address - Street 1:202 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3102
Practice Address - Country:US
Practice Address - Phone:870-932-0150
Practice Address - Fax:870-932-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 3336H0001X
ARAR20370333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147200OtherPK