National Provider Identifier Database

SGOH ACQUISITION INC
Critical Access


Contact Information

SGOH ACQUISITION INC
1101 JACKSON ST SW
GRAVETTE, AR72736-9121
Phone: 479-787-5291
Fax: 479-344-6404
Website:
Specialty Taxonomy Code
* Critical Access 282NC0060X
Clinic/Center 261Q00000X
Critical Access Hospital 261QC0050X
Podiatrist 213E00000X
Psychologist 103T00000X

* Indicates primary specialty

NPI Profile & details for SGOH ACQUISITION INC

NPI Number 1568643005
Legal business name
LBN
SGOH ACQUISITION INC
Authorized official PAUL TAYLOR - (ADMINISTRATOR/CEO)
Entity Organization
Organization subpart No
Enumeration date 11/26/2007
Last updated 07/16/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: AR4517
  • AR Medicaid: 168370105
  • MO Medicaid: 1568643005
  • OK Medicaid: 200200390A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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