State Line Surgical Services, LLC
NPI #1003050444 in Mountain Home, Arkansas
Provider Information
- NPI Number
- 1003050444
- Entity Type
- Organization
- Organization Name
- State Line Surgical Services, LLC
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Apr 29, 2009
- Last Updated
- Dec 16, 2015
Practice Location
- Address
- 1310 EASTSIDE CENTRE CT # 6-142
- City
- Mountain Home
- State
- Arkansas
- ZIP Code
- 72653-2705
- Phone
- (520) 323-8732
Authorized Official
- Name
- LACEY DINH
- Title
- REVENUE CYCLE MANAGER OF ABS
- Phone
- (520) 258-0326
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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