Organization
HEALTHWAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WILLIAM GRAY II BSRT, LRCP (OWNER, RESPIRATORY THERAPIST)
(479) 621-6151
Entity
Organization
Contact information
Practice address
1149 W WALNUT ST, STE B, ROGERS, AR 72756-3543
(479) 621-6151
(479) 621-0172
Mailing address
PO BOX 804, ROGERS, AR 72757-0804
(479) 621-6151
(479) 621-0172
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
001669
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143543716
—
AR
05
—
143544737
—
AR
01
—
49761
BLUECROSS/BLUESHIELD
AR
Enumeration date
06/02/2005
Last updated
10/10/2012
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