Provider Demographics
NPI:1457610099
Name:NATALIE D. HARRIS
Entity Type:Organization
Organization Name:NATALIE D. HARRIS
Other - Org Name:BULLS EYE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MHRM
Authorized Official - Phone:317-612-7693
Mailing Address - Street 1:4811 QUAIL RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-9521
Mailing Address - Country:US
Mailing Address - Phone:317-612-7693
Mailing Address - Fax:
Practice Address - Street 1:4811 QUAIL RIDGE LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-9521
Practice Address - Country:US
Practice Address - Phone:317-612-7693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies