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General NPI Number Information
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NPI Number | 1063415891
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Entity Type | Organization
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Legal Business Name | HARRISON SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 105 SAWGRASS PT
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City | HARRISON
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State | AR
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Zip | 72601-3072
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Country | US
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Telephone | 870-741-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 105 SAWGRASS PT
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City | HARRISON
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State | AR
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Zip | 72601-3072
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Country | US
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Telephone | 870-741-9700
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHARLES MENSCHIK
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Credential |
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Telephone | 870-424-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AR4264
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License Number State | AR
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