Healthcare Provider Details

I. General information

NPI: 1427684075
Provider Name (Legal Business Name): SALINE INVESTMENT GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S SHACKLEFORD RD
LITTLE ROCK AR
72211-4335
US

IV. Provider business mailing address

1701 S SHACKLEFORD RD
LITTLE ROCK AR
72211-4335
US

V. Phone/Fax

Practice location:
  • Phone: 501-219-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN C MENARD
Title or Position: OWNER
Credential: MD
Phone: 501-940-0070