Healthcare Provider Details
I. General information
NPI: 1871135285
Provider Name (Legal Business Name): SCITY OPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2019
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 E VICTORY ST
STAR CITY AR
71667-5327
US
IV. Provider business mailing address
505 E VICTORY ST
STAR CITY AR
71667-5327
US
V. Phone/Fax
- Phone: 870-619-2139
- Fax: 870-628-5316
- Phone: 870-619-2139
- Fax: 870-628-5316
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANTHONY
BRANDON
ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 501-932-0050