Provider Demographics
NPI:1508215880
Name:ORNISH REVERSAL PROGRAM TM AT SALINE HEART GROUP LLC
Entity type:Organization
Organization Name:ORNISH REVERSAL PROGRAM TM AT SALINE HEART GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-315-4008
Mailing Address - Street 1:PO BOX 2860
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-2860
Mailing Address - Country:US
Mailing Address - Phone:501-315-4008
Mailing Address - Fax:501-315-3411
Practice Address - Street 1:1000 HWY 35 N
Practice Address - Street 2:SUITE 8
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-2351
Practice Address - Country:US
Practice Address - Phone:501-315-4008
Practice Address - Fax:501-315-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty