Provider Demographics
NPI:1336375633
Name:HEALTHTRONIX LYMPHEDEMA MANAGEMENT, INC.
Entity type:Organization
Organization Name:HEALTHTRONIX LYMPHEDEMA MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-231-6511
Mailing Address - Street 1:PO BOX 861840
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-1840
Mailing Address - Country:US
Mailing Address - Phone:972-231-6511
Mailing Address - Fax:972-437-5513
Practice Address - Street 1:9700 N. 91ST STREET
Practice Address - Street 2:SUITE B220
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5054
Practice Address - Country:US
Practice Address - Phone:480-614-1233
Practice Address - Fax:480-614-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30766360Medicaid