Provider Demographics
NPI:1245097559
Name:HASELOW ENTERPRISES LLC
Entity type:Organization
Organization Name:HASELOW ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HASELOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-442-8129
Mailing Address - Street 1:9408 MILLERS POINTE CT
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2491
Mailing Address - Country:US
Mailing Address - Phone:501-442-8129
Mailing Address - Fax:
Practice Address - Street 1:9408 MILLERS POINTE CT
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-2491
Practice Address - Country:US
Practice Address - Phone:501-442-8129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren