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NPI Code Detail

MEDICARE: ROYCE A HARRIS

MEDICARE:   ROYCE A HARRIS
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
1172V00000XCommunity Health Worker
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1083969133
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROYCE A HARRIS
Provider Business Mailing Address
First Line : 2914 HOLYOKE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43606
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2914 HOLYOKE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43606
Country : US
Telephone Number : 313-293-8028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 07/16/2012

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Directions to “ ROYCE A HARRIS ” Practice Location

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