MEDICARE: HARMON DIABETES CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1083814032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMON DIABETES CENTER, LLC

Provider Business Mailing Address
First Line	:	2188 E MEYER BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1183
Country	:	US
Telephone Number	:	816-276-9410
Fax Number	:	816-523-3693

Provider Business Practice Location Address
First Line	:	2188 E MEYER BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1183
Country	:	US
Telephone Number	:	816-276-9410
Fax Number	:	816-523-3693

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CYNTHIA RANDAZZO
Credential	:
Telephone Number	:	816-276-4218

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/03/2008

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