Healthcare Provider Details

I. General information

NPI: 1073787693
Provider Name (Legal Business Name): SHILOH HEALTH & REHAB,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 WAGON WHEEL RD
SPRINGDALE AR
72764
US

IV. Provider business mailing address

1092 WAGON WHEEL RD
SPRINGDALE AR
72764
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-3800
  • Fax: 479-750-3010
Mailing address:
  • Phone: 479-750-3800
  • Fax: 479-750-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. DAVID LAMAR NORSWORTHY
Title or Position: COO
Credential:
Phone: 501-944-5633