Vernon Harris

Individual provider Active NPI Case Manager/Care Coordinator · Mabelvale, AR

NPI 1699890772 · NPPES record last updated Jun 4, 2021

Key facts

NPI
1699890772
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
10600 Train Station Dr Ste C
Mabelvale, AR 72103-1644
Phone
(501) 753-8400
Fax
(501) 332-4403
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
TFS of Gurdon Inc Past
since Jun 6, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

10600 Train Station Dr Ste C
Mabelvale, AR 72103-1644

Mailing address

829 Halbert St
Malvern, AR 72104-2607
Phone (501) 332-4400

Other providers in Mabelvale, AR

All providers in Mabelvale, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.