Provider Demographics
NPI:1902051816
Name:SILOAM SPRINGS ARKANSAS HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:SILOAM SPRINGS ARKANSAS HOSPITAL COMPANY LLC
Other - Org Name:SILOAM SPRINGS REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:603 N PROGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-4352
Mailing Address - Country:US
Mailing Address - Phone:479-215-3000
Mailing Address - Fax:
Practice Address - Street 1:603 N PROGRESS AVE
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4352
Practice Address - Country:US
Practice Address - Phone:479-215-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR040001Medicare Oscar/Certification