Provider Demographics
NPI:1407960271
Name:SPRINGHILL MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:SPRINGHILL MEDICAL SERVICES, INC.
Other - Org Name:BRADLEY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATRONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-539-1001
Mailing Address - Street 1:2001 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4526
Mailing Address - Country:US
Mailing Address - Phone:318-539-1000
Mailing Address - Fax:318-539-4085
Practice Address - Street 1:409 WOODRUFF ST
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:AR
Practice Address - Zip Code:71826-8715
Practice Address - Country:US
Practice Address - Phone:870-894-3366
Practice Address - Fax:870-894-3760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGHILL MEDICAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-18
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134262002Medicaid
AR5F635Medicare PIN
AR134262002Medicaid