Organization
ORTHOSOURCE, INC.
Active
Parent organization
ORTHOSOURCE INC.
Other names
Kimlor Medical Supply
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOSOURCE INC.
Authorized official
JAMES HAL DEJARNATT (OWNER)
(479) 373-2510
Entity
Organization
Contact information
Practice address
1675 W JEFFERSON ST STE E, SILOAM SPRINGS, AR 72761-3001
(479) 373-2510
(479) 373-2509
Mailing address
PO BOX 7510, SPRINGDALE, AR 72766-7510
(479) 872-1885
(479) 872-1889
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161293716
—
AR
Enumeration date
01/05/2022
Last updated
04/15/2022
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