OrganizationActive
State Line Surgical Services, LLC
NPI 1003050444 · Health Maintenance Organization · Mountain Home, AR
Provider details
- NPI number
- 1003050444
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Lacey Dinh, Revenue Cycle Manager of Abs(520) 258-0326
Specialties & taxonomies
Managed Care Organizations
Practice location
1310 Eastside Centre Ct # 6-142
Mountain Home, AR 72653-2705
Phone: (520) 323-8732
Fax: (520) 547-1865
Approximate (ZIP-level) locationGet directions
Mailing address
6339 E Speedway Blvd Ste 201
Tucson, AZ 85710-1147
Registry dates
- Enumerated
- 2009-04-29
- Last updated
- 2015-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.