Provider Demographics
NPI:1235385923
Name:SILVER RIDGE PERINATAL CENTER, INC.
Entity Type:Organization
Organization Name:SILVER RIDGE PERINATAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MD
Authorized Official - Phone:928-607-2802
Mailing Address - Street 1:PO BOX 6011
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86402-6011
Mailing Address - Country:US
Mailing Address - Phone:928-607-2802
Mailing Address - Fax:
Practice Address - Street 1:3931 STOCKTON HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-2426
Practice Address - Country:US
Practice Address - Phone:928-681-4273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty