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Organization

ORTHOSOURCE, INC.

Active
Other names
KimLor Medical
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES HAL DEJARNATT (OWNER / PRESIDENT)
(479) 872-1885
Entity
Organization

Contact information

Practice address
830B E ROBINSON AVE, SPRINGDALE, AR 72764-7113
(479) 872-1885
(479) 872-1889
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
332BX2000X
Oxygen Equipment & Supplies (DME)
011957
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
161293716
AR
Enumeration date
07/25/2006
Last updated
10/21/2022
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