MEDICARE: VALERIE HARDEN

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	332B00000X	Durable Medical Equipment & Medical Supplies	05864/11.1	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407104391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE HARDEN

Provider Business Mailing Address
First Line	:	625 S PEAR ORCHARD RD
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 S PEAR ORCHARD RD
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4836
Country	:	US
Telephone Number	:	601-420-0064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	10/28/2022

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Directions to “ VALERIE HARDEN ” Practice Location

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