Basic Information
Provider Information
NPI: 1518464775
EntityType: 2
ReplacementNPI:  
OrganizationName: SPRINGHILL MEDICAL SERVICES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BUTLER-ABSHIRE MEDICAL CLINIC
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2001 DOCTORS DR
Address2:  
City: SPRINGHILL
State: LA
PostalCode: 710754526
CountryCode: US
TelephoneNumber: 3185391000
FaxNumber: 3185394085
Practice Location
Address1: 900 FRANCES DR
Address2:  
City: HAYNESVILLE
State: LA
PostalCode: 710386100
CountryCode: US
TelephoneNumber: 3186240554
FaxNumber: 3186243782
Other Information
ProviderEnumerationDate: 04/12/2018
LastUpdateDate: 04/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SEDMINIK
AuthorizedOfficialFirstName: VINCENT
AuthorizedOfficialMiddleName: R.
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 3185391001
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: SPRINGHILL MEDICAL SERVICES, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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