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Organization

J H HARVEY CO LLC

Active
Other names
Harveys Supermarket Pharmacy #2404
Organization subpart
No

Provider details

NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization

Contact information

Practice address
1451 HIGHWAY 21 S, SPRINGFIELD, GA 31329-5215
(912) 754-7009
(912) 754-7015
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
1159260
NCPDP PROVIDER IDENTIFICATION NUMBER
05
177673313A
GA
Enumeration date
11/09/2009
Last updated
03/11/2011
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