MEDICARE: STEPHEN HARRELL H.I.S

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	237700000X	Hearing Instrument Specialist	HAS-0699	SC

General Provider Information

NPI Number	:	1477318285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN HARRELL H.I.S

Provider Business Mailing Address
First Line	:	1946 MR JOE WHITE AVE
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5624
Country	:	US
Telephone Number	:	843-448-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1946 MR JOE WHITE AVE
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5624
Country	:	US
Telephone Number	:	843-448-0008
Fax Number	:

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

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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