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NPI Code Detail

MEDICARE: SALINE HEART GROUP, P.A.

MEDICARE: SALINE HEART GROUP, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistAR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15F079OTHERARMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35F079OTHERARBCBS

General Provider Information

NPI Number : 1477510220
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALINE HEART GROUP, P.A.
Provider Business Mailing Address
First Line : 1000 HWY 35 N STE 8
Second Line : P.O. BOX 2860
City : BENTON
State : AR
Zip : 72019-2353
Country : US
Telephone Number : 501-315-4008
Fax Number : 501-315-3411
Provider Business Practice Location Address
First Line : 1000 HWY 35 N
Second Line : SUITE 8
City : BENTON
State : AR
Zip : 72019-2351
Country : US
Telephone Number : 501-315-4008
Fax Number : 501-315-3411
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. JAMIE KRTICKA
Credential :
Telephone Number : 501-315-4008
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/21/2022

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Directions to “SALINE HEART GROUP, P.A. ” Practice Location

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