Healthcare Provider Details

I. General information

NPI: 1588849665
Provider Name (Legal Business Name): FORT SMITH HMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TOWSON AVE
FORT SMITH AR
72901-4921
US

IV. Provider business mailing address

1001 TOWSON AVE PO BOX 17006
FORT SMITH AR
72901-4921
US

V. Phone/Fax

Practice location:
  • Phone: 479-441-5365
  • Fax: 479-441-4729
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberAR4421
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY PARRY
Title or Position: SR. VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-598-3131