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1578555736

NPI Code Detail

MEDICARE: FORT SMITH HMA, LLC

MEDICARE: FORT SMITH HMA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician		AR
2	261QM2500X	Medical Specialty Clinic/Center	AR4421	AR
3	273Y00000X	Rehabilitation Hospital Unit	AR4421	AR
4	291U00000X	Clinical Medical Laboratory	AR4421	AR
5	282N00000X	General Acute Care Hospital	AR4421	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	*710236920729010000**	OTHER	AR	TRICARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	10055	OTHER	AR	BC/BS ACUTE
7	5B370	OTHER	AR	AR BCBS
8	15294	OTHER	AR	BCBS SNF

General Provider Information

NPI Number	:	1578555736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT SMITH HMA, LLC

Provider Business Mailing Address
First Line	:	1001 TOWSON AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72902-4921
Country	:	US
Telephone Number	:	479-441-4000
Fax Number	:	479-441-5420

Provider Business Practice Location Address
First Line	:	1001 TOWSON AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-4921
Country	:	US
Telephone Number	:	479-441-5214
Fax Number	:	479-441-3793

Authorized Official
Title or Position	:	DIRECTOR/DELEGATED OFFICIAL
Name	:	PAULA M LALOR
Credential	:
Telephone Number	:	615-925-4565

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	09/19/2017

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Directions to “FORT SMITH HMA, LLC ” Practice Location

Language	Start Address	Practice Location

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