Basic Information
| Provider Information | |||||||||
| NPI: | 1487006938 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARSH | ||||||||
| FirstName: | LEMUEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | IV | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD STE 300N | ||||||||
| Address2: | |||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812862999 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4992 BILL GARDNER PKWY | ||||||||
| Address2: | |||||||||
| City: | LOCUST GROVE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302483647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709149581 | ||||||||
| FaxNumber: | 7709149730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2016 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | GA | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237700000X | HADS000965 | GA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.