Organization
HOSPICE PEACHTREE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM PETRUS (CHIEF EXECUTIVE OFFICER)
(479) 494-0100
Entity
Organization
Contact information
Practice address
2910 JENNY LIND RD, #4, FORT SMITH, AR 72901-6735
(479) 494-0100
Mailing address
2910 JENNY LIND RD, #4, FORT SMITH, AR 72901-6735
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
AR 4137
AR
Other
Enumeration date
09/12/2008
Last updated
03/25/2013
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