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General NPI Number Information
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NPI Number | 1033482906
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Entity Type | Organization
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Legal Business Name | HARVEST HEALTH SOLUTIONS, PLLC
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 574 GREEN TREE CV SUITE 203
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2562
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Country | US
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Telephone | 901-850-2233
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Fax | 901-850-9911
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Provider Business Mailing Address
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Address Line | 574 GREEN TREE CV SUITE 203
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2562
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Country | US
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Telephone | 901-850-2233
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Fax | 901-850-9911
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA L. CARMACK
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Credential |
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Telephone | 901-850-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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