Provider Demographics
NPI:1639666274
Name:SILOAM HEALTHCARE LLC
Entity type:Organization
Organization Name:SILOAM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-333-4369
Mailing Address - Street 1:811 W ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-2327
Mailing Address - Country:US
Mailing Address - Phone:479-524-3128
Mailing Address - Fax:479-524-2296
Practice Address - Street 1:811 W ELGIN ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-2327
Practice Address - Country:US
Practice Address - Phone:479-524-3128
Practice Address - Fax:479-524-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility