Provider Demographics
NPI:1073705554
Name:HARWELL, LINDA GAIL
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GAIL
Last Name:HARWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-4909
Mailing Address - Country:US
Mailing Address - Phone:937-680-0594
Mailing Address - Fax:931-680-0579
Practice Address - Street 1:503 MADISON ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-4909
Practice Address - Country:US
Practice Address - Phone:937-680-0594
Practice Address - Fax:931-680-0579
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies