Provider Demographics
NPI:1811991193
Name:HEALTHWAY INC
Entity type:Organization
Organization Name:HEALTHWAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:II
Authorized Official - Credentials:BSRT, LRCP
Authorized Official - Phone:479-621-6151
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72757-0804
Mailing Address - Country:US
Mailing Address - Phone:479-621-6151
Mailing Address - Fax:479-621-0172
Practice Address - Street 1:1149 W WALNUT ST
Practice Address - Street 2:STE B
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3543
Practice Address - Country:US
Practice Address - Phone:479-621-6151
Practice Address - Fax:479-621-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR001669332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143544737Medicaid
AR143543716Medicaid
AR49761OtherBLUECROSS/BLUESHIELD
AR143544737Medicaid
AR49761OtherBLUECROSS/BLUESHIELD