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General NPI Number Information
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NPI Number | 1174769673
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Entity Type | Organization
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Legal Business Name | HALLMARK MEDICAL, LLC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 900 RANCHWOOD DR
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City | WILBURTON
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State | OK
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Zip | 74578-3630
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Country | US
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Telephone | 479-434-0239
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Fax | 479-434-4403
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Provider Business Mailing Address
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Address Line | PO BOX 6318
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City | FORT SMITH
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State | AR
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Zip | 72906-6318
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Country | US
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Telephone | 479-434-0239
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JEFF L BUTCHER
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Credential |
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Telephone | 479-434-0239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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