MEDICARE: CITY OF SILOAM SPRINGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146L00000X	Paramedic	162	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174558530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF SILOAM SPRINGS

Provider Business Mailing Address
First Line	:	PO BOX 80
Second Line	:	400 N BROADWAY
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761
Country	:	US
Telephone Number	:	479-524-3103
Fax Number	:	479-524-6132

Provider Business Practice Location Address
First Line	:	1450 CHERI WHITLOCK DR
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-2009
Country	:	US
Telephone Number	:	479-524-3103
Fax Number	:	479-524-6132

Authorized Official
Title or Position	:	FINANCE ACCOUNTING MANAGER
Name	:	KIMBERLY WILLIAMS
Credential	:
Telephone Number	:	479-238-0910

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/11/2023

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Directions to “CITY OF SILOAM SPRINGS ” Practice Location

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