Provider Demographics
NPI:1174558530
Name:CITY OF SILOAM SPRINGS
Entity type:Organization
Organization Name:CITY OF SILOAM SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-238-0910
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:400 N BROADWAY
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761
Mailing Address - Country:US
Mailing Address - Phone:479-524-3103
Mailing Address - Fax:479-524-6132
Practice Address - Street 1:1450 CHERI WHITLOCK DR
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-2009
Practice Address - Country:US
Practice Address - Phone:479-524-3103
Practice Address - Fax:479-524-6132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR162146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR120227715Medicaid
OK100817960BMedicaid
AR120227715Medicaid