Organization
J.H. HARVEY CO., LLC
Active
Other names
Harveys Supermarket Pharmacy #2405
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
1605 SHURLING DR, MACON, GA 31211-2150
(478) 745-0004
(478) 746-0240
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159880
NCPDP NUMBER
—
05
—
868170848A
—
GA
Enumeration date
05/25/2010
Last updated
06/30/2011
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