Provider Demographics
NPI:1891055299
Name:CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM
Other - Org Name:LITTLE ROCK VA HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:APN-C, CWOCN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:BARIS
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:501-257-5900
Mailing Address - Street 1:4300 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5446
Mailing Address - Country:US
Mailing Address - Phone:501-257-5900
Mailing Address - Fax:501-257-1549
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:ATTN: 118LR/WOCN
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-5900
Practice Address - Fax:501-257-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03695261Q00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center