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General NPI Number Information
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NPI Number | 1801772611
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Entity Type | Organization
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Legal Business Name | HARVEST HEALTH LLC
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1207 5TH ST SE
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City | CAIRO
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State | GA
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Zip | 39828-3144
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Country | US
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Telephone | 229-231-3727
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Fax | 229-230-4046
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Provider Business Mailing Address
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Address Line | 1207 5TH ST SE
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City | CAIRO
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State | GA
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Zip | 39828-3144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBYN LONG
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Credential | DO
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Telephone | 229-231-3727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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