Provider Demographics
NPI:1346641081
Name:HARRIS, HENRY EUGENE
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:EUGENE
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 JOHNSON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31705-3059
Mailing Address - Country:US
Mailing Address - Phone:229-449-3231
Mailing Address - Fax:229-883-3010
Practice Address - Street 1:217 JOHNSON RD
Practice Address - Street 2:SUITE C
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-3059
Practice Address - Country:US
Practice Address - Phone:229-449-3231
Practice Address - Fax:229-883-3010
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance