Healthcare Provider Details

I. General information

NPI: 1750979019
Provider Name (Legal Business Name): HARMONY HEALTH AFFILIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 BARNWOOD DR
EDGEWOOD KY
41017-2501
US

IV. Provider business mailing address

166 BARNWOOD DR
EDGEWOOD KY
41017-2501
US

V. Phone/Fax

Practice location:
  • Phone: 859-462-9771
  • Fax:
Mailing address:
  • Phone: 859-462-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: AUTUMN THOMAS
Title or Position: MEMBER
Credential:
Phone: 859-462-9771