Provider Demographics
NPI:1053488320
Name:HAROLD L. COHEN, M.D., LLC
Entity Type:Organization
Organization Name:HAROLD L. COHEN, M.D., LLC
Other - Org Name:OPHTHALMOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER-PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-332-4184
Mailing Address - Street 1:2901 S MCINTIRE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4209
Mailing Address - Country:US
Mailing Address - Phone:812-332-4184
Mailing Address - Fax:812-332-3062
Practice Address - Street 1:2901 S MCINTIRE DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4209
Practice Address - Country:US
Practice Address - Phone:812-332-4184
Practice Address - Fax:812-332-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5435450001Medicare NSC