Healthcare Provider Details

I. General information

NPI: 1861174880
Provider Name (Legal Business Name): HARKEMAC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16063 HIGHWAY 69 S
MOUNDVILLE AL
35474-6209
US

IV. Provider business mailing address

PO BOX 687
MOUNDVILLE AL
35474-0687
US

V. Phone/Fax

Practice location:
  • Phone: 205-371-2267
  • Fax: 205-371-2901
Mailing address:
  • Phone: 205-371-2267
  • Fax: 205-371-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NICOLE JONES
Title or Position: BILLING MANAGER
Credential:
Phone: 205-710-6129