Provider Demographics
NPI:1407156755
Name:HALO MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:HALO MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-806-5295
Mailing Address - Street 1:1053 RAMBLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2094
Mailing Address - Country:US
Mailing Address - Phone:859-699-5224
Mailing Address - Fax:859-523-7399
Practice Address - Street 1:195 OLD MAIN ST
Practice Address - Street 2:SUITE #202
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9119
Practice Address - Country:US
Practice Address - Phone:270-524-2001
Practice Address - Fax:270-524-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies