Organization
J.H. HARVEY CO., LLC
Active
Other names
Harveys Supermarket Pharmacy #2312
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
341 VENTURE DR, BRUNSWICK, GA 31525-9723
(912) 264-2190
(912) 264-5564
Mailing address
PO BOX 1000, MS3000, PORTLAND, ME 04104-5005
(207) 885-7454
(207) 396-2028
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009031
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154260
NCPDP NUMBER
—
05
—
636499135B
—
GA
Enumeration date
07/03/2006
Last updated
03/15/2011
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