Provider Demographics
NPI:1932397817
Name:HARDT EYE CLINIC INC
Entity Type:Organization
Organization Name:HARDT EYE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:HARDT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:670-235-2030
Mailing Address - Street 1:BOX 504768
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:UM
Mailing Address - Phone:670-235-2030
Mailing Address - Fax:670-235-2033
Practice Address - Street 1:BOX 504768
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:UM
Practice Address - Phone:670-235-2030
Practice Address - Fax:670-235-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H56510Medicare PIN
T10697Medicare UPIN
U36114Medicare UPIN
56514 MPMedicare PIN
56512Medicare PIN