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General NPI Number Information
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NPI Number | 1578608956
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Entity Type | Individual
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Provider Name | JAMES ROBERT HARDENSTINE
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 55 STOAKLEY RD 2ND FLOOR
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3859
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Country | US
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Telephone | 410-414-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3541
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-2551
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Country | US
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Telephone | 410-414-3000
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Fax | 410-414-3000
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 04187309
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License Number State | MD
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