Provider Demographics
NPI:1730678590
Name:HAL MEDICAL O&P TENNESSEE, LLC
Entity Type:Organization
Organization Name:HAL MEDICAL O&P TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-284-8872
Mailing Address - Street 1:117 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3231
Mailing Address - Country:US
Mailing Address - Phone:866-284-8872
Mailing Address - Fax:866-979-1771
Practice Address - Street 1:117 W MADISON ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-3231
Practice Address - Country:US
Practice Address - Phone:866-284-8872
Practice Address - Fax:866-979-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies