Provider Demographics
NPI:1710030317
Name:H&L MEDICAL SPECIALIST INC
Entity Type:Organization
Organization Name:H&L MEDICAL SPECIALIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-945-2883
Mailing Address - Street 1:3014 N HAYDEN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6531
Mailing Address - Country:US
Mailing Address - Phone:480-945-2883
Mailing Address - Fax:
Practice Address - Street 1:20 E WHITE MOUNTAIN BLVD B1
Practice Address - Street 2:
Practice Address - City:PINETOP
Practice Address - State:AZ
Practice Address - Zip Code:85935
Practice Address - Country:US
Practice Address - Phone:928-367-2744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20099260332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1101190002Medicare ID - Type Unspecified