Healthcare Provider Details

I. General information

NPI: 1174558530
Provider Name (Legal Business Name): CITY OF SILOAM SPRINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/11/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHERI WHITLOCK DR
SILOAM SPRINGS AR
72761-2009
US

IV. Provider business mailing address

PO BOX 80 400 N BROADWAY
SILOAM SPRINGS AR
72761
US

V. Phone/Fax

Practice location:
  • Phone: 479-524-3103
  • Fax: 479-524-6132
Mailing address:
  • Phone: 479-524-3103
  • Fax: 479-524-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number162
License Number StateAR

VIII. Authorized Official

Name: KIMBERLY WILLIAMS
Title or Position: FINANCE ACCOUNTING MANAGER
Credential:
Phone: 479-238-0910