Organization
J.H. HARVEY CO., LLC
Active
Other names
Harveys Supermarket Pharmacy #2412
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
1945 VETERANS BLVD, DUBLIN, GA 31021-3001
(478) 272-8851
(478) 274-8878
Mailing address
PO BOX 1000, MS3000, PORTLAND, ME 04104-5005
(207) 885-7454
(207) 885-3121
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116745A
—
GA
01
—
1161809
NCPDP PROVIDER NUMBER
—
Enumeration date
10/19/2011
Last updated
12/13/2012
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