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General NPI Number Information
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NPI Number | 1033584073
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Entity Type | Organization
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Legal Business Name | SILOAM SPRINGS CLINIC COMPANY, LLC
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 3721 EAST 412 HWY SUITE B
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761
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Country | US
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Telephone | 615-465-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8786
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City | BELFAST
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State | ME
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Zip | 04915-8786
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Country | US
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Telephone | 615-465-7000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. PAULA DURHAM
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Credential |
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Telephone | 615-465-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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