MEDICARE: HARVEST HEALTHCARE SOLUTIONS 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1285334631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEST HEALTHCARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	125 FOX LN
Second Line	:
City	:	CHESTER
State	:	WV
Zip	:	26034-1601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 FOX LN
Second Line	:
City	:	CHESTER
State	:	WV
Zip	:	26034-1601
Country	:	US
Telephone Number	:	304-387-0101
Fax Number	:

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	MR. MATTHEW MURRAY
Credential	:
Telephone Number	:	304-387-0101

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/06/2023

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