Provider Demographics
NPI:1932692571
Name:BSA HARRINGTON PHYSICIANS INC
Entity Type:Organization
Organization Name:BSA HARRINGTON PHYSICIANS INC
Other - Org Name:BSA HARRINGTON PHYSICIAN, INC. PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PETROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-296-3000
Mailing Address - Street 1:1500 WALLACE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1794
Mailing Address - Country:US
Mailing Address - Phone:806-212-1944
Mailing Address - Fax:806-356-1903
Practice Address - Street 1:1751 WALLACE BLVD STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1711
Practice Address - Country:US
Practice Address - Phone:806-212-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320973336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy