Organization
HARRISON MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY W HARRISON (SEC-TREAS)
(502) 589-9325
Entity
Organization
Contact information
Practice address
721 SOUTH PRESTON ST., LOUISVILLE, KY 40203
(502) 589-9325
(502) 585-5202
Mailing address
721 SOUTH PRESTON ST., LOUISVILLE, KY 40203
(502) 589-9325
(502) 585-5202
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070036
ANTHEM
—
01
—
1050370
PASSPORT
KY
01
—
2432836000
PASSPORT ADVANTAGE
KY
05
—
90210568
—
KY
Enumeration date
07/10/2006
Last updated
02/28/2008
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