Provider Demographics
NPI:1962969725
Name:BE HEALTHY MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:BE HEALTHY MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:479-866-9411
Mailing Address - Street 1:6 N HARVEY DOWELL RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-0721
Mailing Address - Country:US
Mailing Address - Phone:479-866-9411
Mailing Address - Fax:
Practice Address - Street 1:1583 MAIN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5214
Practice Address - Country:US
Practice Address - Phone:479-443-0800
Practice Address - Fax:479-443-5538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center