Healthcare Provider Details

I. General information

NPI: 1871507616
Provider Name (Legal Business Name): SPRINGHILL MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 11TH ST NE
SPRINGHILL LA
71075-4503
US

IV. Provider business mailing address

401 11TH ST NE
SPRINGHILL LA
71075-4503
US

V. Phone/Fax

Practice location:
  • Phone: 318-539-1700
  • Fax: 318-539-5688
Mailing address:
  • Phone: 318-539-1700
  • Fax: 318-539-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number105
License Number StateLA

VIII. Authorized Official

Name: MICHAEL G PATRONIS
Title or Position: CEO
Credential:
Phone: 318-539-1001