Healthcare Provider Details

I. General information

NPI: 1598264186
Provider Name (Legal Business Name): GAMMA HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 02/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2650
US

IV. Provider business mailing address

1717 W MAUD ST
POPLAR BLUFF MO
63901-4003
US

V. Phone/Fax

Practice location:
  • Phone: 501-945-4057
  • Fax:
Mailing address:
  • Phone: 573-727-5600
  • Fax: 573-785-0753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: JERRY W MURPHY
Title or Position: CHAIRMAN & CEO
Credential:
Phone: 573-727-5600