MEDICARE: HEALTHWAY INC

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	332BX2000X	Oxygen Equipment & Supplies (DME)	001669	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	49761	OTHER	AR	BLUECROSS/BLUESHIELD

General Provider Information

NPI Number	:	1811991193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWAY INC

Provider Business Mailing Address
First Line	:	PO BOX 804
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72757-0804
Country	:	US
Telephone Number	:	479-621-6151
Fax Number	:	479-621-0172

Provider Business Practice Location Address
First Line	:	1149 W WALNUT ST
Second Line	:	STE B
City	:	ROGERS
State	:	AR
Zip	:	72756-3543
Country	:	US
Telephone Number	:	479-621-6151
Fax Number	:	479-621-0172

Authorized Official
Title or Position	:	OWNER, RESPIRATORY THERAPIST
Name	:	MR. THOMAS WILLIAM GRAY II
Credential	:	BSRT, LRCP
Telephone Number	:	479-621-6151

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	10/10/2012

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Directions to “HEALTHWAY INC ” Practice Location

Language	Start Address	Practice Location

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