Provider Demographics
NPI:1770880494
Name:HARBOR MEDICAL INC
Entity type:Organization
Organization Name:HARBOR MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-692-5629
Mailing Address - Street 1:3519 GLENOAK DR
Mailing Address - Street 2:
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-1837
Mailing Address - Country:US
Mailing Address - Phone:410-692-5629
Mailing Address - Fax:
Practice Address - Street 1:3519 GLENOAK DR
Practice Address - Street 2:
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084-1837
Practice Address - Country:US
Practice Address - Phone:410-692-5629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies