Organization
J.H. HARVEYS CO.
Active
Other names
Harveys Supermarket Pharmacy #2380
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
12246 COLUMBIA ST STE F, BLAKELY, GA 39823-2560
(229) 723-5202
(229) 423-5221
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
PHRE012217
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE012217
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1155414
NCPDP
GA
05
—
501975150A
—
GA
Enumeration date
02/15/2007
Last updated
03/11/2011
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