Provider Demographics
NPI:1578608956
Name:HARDENSTINE, JAMES ROBERT
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:HARDENSTINE
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:PO BOX 3541
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-2551
Mailing Address - Country:US
Mailing Address - Phone:410-414-3000
Mailing Address - Fax:410-414-3000
Practice Address - Street 1:55 STOAKLEY RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3859
Practice Address - Country:US
Practice Address - Phone:410-414-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04187309332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies