Provider Demographics
NPI:1679613244
Name:HARRISON MEDICAL CENTER
Entity Type:Organization
Organization Name:HARRISON MEDICAL CENTER
Other - Org Name:HARRISON URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-744-6505
Mailing Address - Street 1:2520 CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4229
Mailing Address - Country:US
Mailing Address - Phone:360-744-3911
Mailing Address - Fax:
Practice Address - Street 1:450 S KITSAP BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3773
Practice Address - Country:US
Practice Address - Phone:360-744-6275
Practice Address - Fax:360-744-6270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRISON MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1016140Medicaid
WA104767OtherLABOR AND INDUSTRIES
G115135800Medicare PIN
WAGAB115135800Medicare PIN