Healthcare Provider Details

I. General information

NPI: 1033329024
Provider Name (Legal Business Name): HARBOR HEALTHCARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 N 11TH ST
BEAUMONT TX
77702-2224
US

IV. Provider business mailing address

95 N 11TH ST
BEAUMONT TX
77702-2224
US

V. Phone/Fax

Practice location:
  • Phone: 409-813-2332
  • Fax:
Mailing address:
  • Phone: 409-813-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: JANET R MONTAGNE
Title or Position: PRESIDENT OF FINANCE
Credential:
Phone: 409-201-9655