Provider Demographics
NPI:1891176517
Name:HAL MEDICAL O&P, PC
Entity Type:Organization
Organization Name:HAL MEDICAL O&P, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BERRYHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-444-4740
Mailing Address - Street 1:2245 COUNTY ROAD 93
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:AL
Mailing Address - Zip Code:35610-4125
Mailing Address - Country:US
Mailing Address - Phone:256-444-4740
Mailing Address - Fax:256-230-2323
Practice Address - Street 1:22923 US HIGHWAY 72 STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-7618
Practice Address - Country:US
Practice Address - Phone:256-230-2321
Practice Address - Fax:256-444-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL612335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7463250001Medicare NSC