Provider Demographics
NPI:1124445226
Name:HARDIN PROFESSIONAL SERVICES
Entity type:Organization
Organization Name:HARDIN PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-706-1900
Mailing Address - Street 1:PO BOX 2119
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-2119
Mailing Address - Country:US
Mailing Address - Phone:270-706-1565
Mailing Address - Fax:270-382-2128
Practice Address - Street 1:2407 RING RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-5937
Practice Address - Country:US
Practice Address - Phone:270-735-1588
Practice Address - Fax:270-735-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site