Organization
J H HARVEY CO LLC
Active
Other names
Harveys Supermarket Pharmacy #2306
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
813 PETERSON AVE S, DOUGLAS, GA 31533-5234
(912) 383-6862
(912) 383-6745
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
—
1153321
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
991274720A
—
GA
Enumeration date
08/28/2006
Last updated
03/11/2011
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