Healthcare Provider Details

I. General information

NPI: 1801970710
Provider Name (Legal Business Name): SALINE HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23157 INTERSTATE 30 S
BRYANT AR
72022-9905
US

IV. Provider business mailing address

1 MEDICAL PARK DR
BENTON AR
72015-3353
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-0136
  • Fax: 501-776-6677
Mailing address:
  • Phone: 501-776-6000
  • Fax: 501-776-6019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAR5221
License Number StateAR

VIII. Authorized Official

Name: KATHY J. TEAGUE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000