Healthcare Provider Details
I. General information
NPI: 1508976671
Provider Name (Legal Business Name): NEW HOPE PROSTHETICS & ORTHODICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 W 40TH AVE STE 4A
PINE BLUFF AR
71603
US
IV. Provider business mailing address
510 FOREST RIDGE RD
ROYAL AR
71968-9343
US
V. Phone/Fax
- Phone: 870-536-2171
- Fax: 870-536-2183
- Phone: 870-489-1803
- Fax: 870-536-2183
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | OPP0059 |
| License Number State | AR |
VIII. Authorized Official
Name: MR.
GABRIEL
GALSTER
SR.
Title or Position: PRESIDENT/CEO
Credential: CP, LPO
Phone: 870-536-2171