Provider Demographics
NPI:1871527002
Name:HARRISON MEDIQUICK PA
Entity type:Organization
Organization Name:HARRISON MEDIQUICK PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-741-7612
Mailing Address - Street 1:PO BOX 1496
Mailing Address - Street 2:724 N SPRING ST
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602
Mailing Address - Country:US
Mailing Address - Phone:870-741-2500
Mailing Address - Fax:870-741-7618
Practice Address - Street 1:724 N SPRING STREET
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-2500
Practice Address - Fax:870-741-7618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care