Provider Demographics
NPI:1780770289
Name:SALINE COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:SALINE COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-776-6000
Mailing Address - Street 1:1 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3353
Mailing Address - Country:US
Mailing Address - Phone:501-776-6000
Mailing Address - Fax:501-776-6048
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3353
Practice Address - Country:US
Practice Address - Phone:501-776-6000
Practice Address - Fax:501-776-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04S084Medicare ID - Type UnspecifiedMEDICARE GENERATIONS
AR047043Medicare ID - Type UnspecifiedMEDICARE HOME HEALTH
AR041550Medicare ID - Type UnspecifiedMEDICARE HOSPICE
AR45204Medicare Oscar/Certification
AR04T084Medicare Oscar/Certification