1255575023 NPI number — HARWELL THERAPY SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255575023 NPI number — HARWELL THERAPY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARWELL THERAPY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INTEGRATED THERAPY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255575023
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 E EVERETT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POCAHONTAS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72455-3309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-248-1448
Provider Business Mailing Address Fax Number:
870-248-1450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 E EVERETT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POCAHONTAS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72455-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-248-1448
Provider Business Practice Location Address Fax Number:
870-248-1450
Provider Enumeration Date:
04/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HARWELL
Authorized Official First Name:
BRITNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
870-248-1448

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  P0403013 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: OTR1655 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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