Organization
J.H. HARVEY CO., LLC
Active
Other names
Harveys Supemarket Pharmacy #2332
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
220 W CENTRAL AVE, FITZGERALD, GA 31750
(229) 423-0521
(229) 423-7147
Mailing address
PO BOX 1000, MS 3000, PORTLAND, ME 04104
(207) 885-7454
(207) 396-2028
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE009037
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006823270
—
GA
01
—
1154462
NCPDP
GA
Enumeration date
07/08/2006
Last updated
03/15/2011
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