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NPI Code Detail

MEDICARE: SAMANTHA HEDRICK MHPP

MEDICARE: SAMANTHA HEDRICK MHPP
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
1171M00000XCase Manager/Care CoordinatorAR

General Provider Information

NPI Number : 1720115629
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA HEDRICK MHPP
Provider Business Mailing Address
First Line : 311 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3407
Country : US
Telephone Number : 501-623-3477
Fax Number :
Provider Business Practice Location Address
First Line : 311 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3407
Country : US
Telephone Number : 501-623-3477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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