MEDICARE: ORNISH REVERSAL PROGRAM TM AT SALINE HEART GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1508215880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORNISH REVERSAL PROGRAM TM AT SALINE HEART GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 2860
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72018-2860
Country	:	US
Telephone Number	:	501-315-4008
Fax Number	:	501-315-3411

Provider Business Practice Location Address
First Line	:	1000 HWY 35 N
Second Line	:	SUITE 8
City	:	BENTON
State	:	AR
Zip	:	72019-2351
Country	:	US
Telephone Number	:	501-315-4008
Fax Number	:	501-315-3411

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. ALLAN B HATCH
Credential	:	M.D
Telephone Number	:	501-315-4008

Provider Enumeration Date	:	06/08/2016
Last Update Date	:	07/07/2016

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Directions to “ORNISH REVERSAL PROGRAM TM AT SALINE HEART GROUP LLC ” Practice Location

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