1891837506 NPI number — HARRIS CHIROPRACTIC CENTER INC

Table of content: (NPI 1891837506)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891837506 NPI number — HARRIS CHIROPRACTIC CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIS CHIROPRACTIC CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891837506
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1025 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46131-1240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-736-7088
Provider Business Mailing Address Fax Number:
317-736-8351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1025 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46131-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-736-7088
Provider Business Practice Location Address Fax Number:
317-736-8351
Provider Enumeration Date:
02/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
ELMER
Authorized Official Middle Name:
CURTIS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
317-736-7088

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  08001207 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000180952 . This is a "ANTHEM BCBS - CENTRAL INDIANA CHIROPRACTIC" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 9231076 . This is a "PCHS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000073133 . This is a "ANTHEM BCBS HARRIS CHIROPRACTIC CENTER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 083361 . This is a "SIHO" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200893480 A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0004384774 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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