Provider Demographics
NPI:1649321886
Name:HARDY ENTERPRISES INC
Entity type:Organization
Organization Name:HARDY ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-355-1049
Mailing Address - Street 1:2699 SANDLIN RD SW
Mailing Address - Street 2:SUITE A3
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-7344
Mailing Address - Country:US
Mailing Address - Phone:256-355-1049
Mailing Address - Fax:866-525-0439
Practice Address - Street 1:2699 SANDLIN RD SW
Practice Address - Street 2:SUITE A3
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-7344
Practice Address - Country:US
Practice Address - Phone:256-355-1049
Practice Address - Fax:866-525-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1121261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALT68434Medicare UPIN