NPI 1003050444

State Line Surgical Services, LLC

Organisation Health Maintenance Organization Mountain Home, AR

Practice location

Address: 1310 Eastside Centre CT # 6-142, Mountain Home, AR 72653-2705
Phone: (520) 323-8732
Fax: (520) 547-1865
Mailing address: 6339 E Speedway Blvd STE 201, Tucson, AZ 85710-1147

Authorised official

Name: Lacey Dinh
Title: Revenue Cycle Manager of Abs
Phone: (520) 258-0326

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

Other Health Maintenance Organization providers in Arkansas →

Registry record

NPI: 1003050444
Entity type: Organization
NPI issued: 29 Apr 2009
Record last updated: 16 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.