Provider Demographics
NPI:1013067438
Name:HARKNESS CARRIERS
Entity type:Organization
Organization Name:HARKNESS CARRIERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:HARKNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-887-5969
Mailing Address - Street 1:PO BOX 2281
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88221-2281
Mailing Address - Country:US
Mailing Address - Phone:505-887-5969
Mailing Address - Fax:
Practice Address - Street 1:605 N GUADALUPE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5053
Practice Address - Country:US
Practice Address - Phone:505-887-5969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNMPRC00480483416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR3516Medicaid
NMR3516Medicaid