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Individual

MR. CARL CHRIS HARRIS SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
102 S 1ST ST, JESUP, GA 31545-1171
(912) 588-1035
(912) 588-7016
Mailing address
102 S 1ST ST, JESUP, GA 31545-1171
(912) 588-1035
(912) 588-7016

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13029
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13029
STATE PHARMACIST LICENSE NUMBER
GA
Enumeration date
05/22/2010
Last updated
05/22/2010
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