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1659354678

NPI Code Detail

MEDICARE: EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES

MEDICARE: EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036055965	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4000429	OTHER		AETNA
2	4000541	OTHER		AETNA
3	117845	OTHER		HEALTHLINK
4	111193	OTHER		GHP
5	31740	OTHER		GHP
6	45307	OTHER		GHP
7	0006010035	OTHER	IL	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	100723	OTHER		HEALTHLINK
10	CL3745	OTHER		TRAVELERS
11	1107134	OTHER		UHC
12	5241	OTHER		ADVANTRA/GHP

General Provider Information

NPI Number	:	1659354678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 952009
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-2009
Country	:	US
Telephone Number	:	314-821-8055
Fax Number	:	314-821-1833

Provider Business Practice Location Address
First Line	:	1 MEMORIAL DR
Second Line	:
City	:	ALTON
State	:	IL
Zip	:	62002-6722
Country	:	US
Telephone Number	:	618-463-7410
Fax Number	:	618-463-7641

Authorized Official
Title or Position	:	M.D.
Name	:	EDWARD J HARROW
Credential	:
Telephone Number	:	618-463-7410

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	06/25/2008

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Directions to “EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES ” Practice Location

Language	Start Address	Practice Location

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