Organization Active NPI

Edward J Harrow PTR, Alton Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Alton, IL
National Provider Identifier
1659354678
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036055965 Issued in IL
Legal business name
EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES
Practice address
1 Memorial Dr
Alton, IL 62002-6722
Phone
(618) 463-7410
Fax
(618) 463-7641
NPI assigned
Nov 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward J Harrow
Title
M.D.
Phone
(618) 463-7410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 036055965 IL Primary

Addresses

Primary practice location

1 Memorial Dr
Alton, IL 62002-6722

Mailing address

PO Box 952009
Saint Louis, MO 63195-2009
Phone (314) 821-8055

Other identifiers 12

IdentifierTypeStateIssuer
4000429OtherAETNA
4000541OtherAETNA
117845OtherHEALTHLINK
111193OtherGHP
31740OtherGHP
45307OtherGHP
0006010035OtherILBCBS
036055965MedicaidIL
100723OtherHEALTHLINK
CL3745OtherTRAVELERS
1107134OtherUHC
5241OtherADVANTRA/GHP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1659354678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952009",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952009",
            "telephone_number": "314-821-8055",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7410",
            "fax_number": "618-463-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "HARROW",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "618-463-7410"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036055965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4000429",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4000541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "117845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "111193",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "31740",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "45307",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0006010035",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055965",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "100723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS",
            "identifier": "CL3745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1107134",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA/GHP",
            "identifier": "5241",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.