St Mary'S Physician Services Llc
LBN: St Mary'S Physician Services Llc
St Mary'S Physician Services Llc is an health care organization with primary practice located at 101 Skyline Dr , Russellville AR 72801-3363. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty.
St Mary'S Physician Services Llc can be contacted via phone (479) 968-2345, or through Bowman, Monic via phone (615) 920-7000.
Contact Information
Primary practice address
101 Skyline Dr
Russellville AR 72801-3363
Phone: (479) 968-2345
Fax: (479) 890-2497
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X |
Profile Details
| NPI number | 1124084991 |
|---|---|
| LBN Legal business name | St Mary'S Physician Services Llc |
| DBA Doing business as | |
| Authorized official | Bowman, Monic |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | Feb 7th, 2023 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124084991 | NPPES |
| Other | DA8026 | RAILROAD MEDICARE PTAN | |
| MEDICAID | 152955002 | RAILROAD MEDICARE PTAN |
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