Provider Demographics
NPI:1912599028
Name:HARDWICK, SHERIDAN FARROND
Entity Type:Individual
Prefix:MR
First Name:SHERIDAN
Middle Name:FARROND
Last Name:HARDWICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20315
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30325-0315
Mailing Address - Country:US
Mailing Address - Phone:404-454-8443
Mailing Address - Fax:
Practice Address - Street 1:3770 ROCKPORT PL SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-3731
Practice Address - Country:US
Practice Address - Phone:404-454-8443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)