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General NPI Number Information
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NPI Number | 1154607240
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Entity Type | Organization
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Legal Business Name | HARVEY DURHAM MEDICAL, LLC
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 3443 DICKERSON PIKE SKYLINE MEDICAL PLAZA, SUITE G-20
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City | NASHVILLE
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State | TN
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Zip | 37207-2519
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Country | US
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Telephone | 615-739-5831
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Fax | 615-739-5896
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Provider Business Mailing Address
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Address Line | 109 SE 1ST AVE
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City | OCALA
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State | FL
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Zip | 34471-2163
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Country | US
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Telephone | 352-867-8899
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Fax | 352-867-8864
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Authorized Official
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Title or Position | OPERATING MANAGER
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Name | ROBERT KUYKENDALL
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Credential |
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Telephone | 615-815-9851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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