Healthcare Provider Details
I. General information
NPI: 1871828467
Provider Name (Legal Business Name): FORT SMITH HMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2009
Last Update Date: 10/15/2009
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
FORT SMITH AR
72901-4921
US
V. Phone/Fax
- Phone: 479-441-4000
- Fax: 479-441-5397
- Phone: 479-441-4000
- Fax: 479-441-5397
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273Y00000X |
| Taxonomy | Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIMOTHY
PARRY
Title or Position: SR. VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-552-3458