Provider Demographics
NPI:1285067579
Name:HEALING HEARTS HOME MEDICAL SUPPLY
Entity type:Organization
Organization Name:HEALING HEARTS HOME MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMRIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-394-8055
Mailing Address - Street 1:1100 HIGHWAY 71 N STE B
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8414
Mailing Address - Country:US
Mailing Address - Phone:479-394-8055
Mailing Address - Fax:479-394-8045
Practice Address - Street 1:1100 HIGHWAY 71 N STE B
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8414
Practice Address - Country:US
Practice Address - Phone:479-394-8045
Practice Address - Fax:479-394-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition