Healthcare Provider Details

I. General information

NPI: 1710030317
Provider Name (Legal Business Name): H&L MEDICAL SPECIALIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E WHITE MOUNTAIN BLVD B1
PINETOP AZ
85935
US

IV. Provider business mailing address

3014 N HAYDEN RD STE 103
SCOTTSDALE AZ
85251-6531
US

V. Phone/Fax

Practice location:
  • Phone: 928-367-2744
  • Fax:
Mailing address:
  • Phone: 480-945-2883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number20099260
License Number StateAZ

VIII. Authorized Official

Name: LORI GREENBECK
Title or Position: OWNER
Credential:
Phone: 480-945-2883