Provider Demographics
NPI:1952152480
Name:THOMAS- HARP, JAVARIUS
Entity Type:Individual
Prefix:
First Name:JAVARIUS
Middle Name:
Last Name:THOMAS- HARP
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 1:1703 RACE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-3847
Mailing Address - Country:US
Mailing Address - Phone:313-488-9924
Mailing Address - Fax:
Practice Address - Street 1:1703 RACE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3847
Practice Address - Country:US
Practice Address - Phone:313-488-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide