Organization
J.H. HARVEY CO., LLC
Active
Other names
Harveys Supermarket Pharmacy #2406
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
775 GA HWY 122 W, HAHIRA, GA 31632
(229) 794-2989
(229) 794-0089
Mailing address
PO BOX 1000, MAILSORT 3000, 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
05
—
003106841A
—
GA
01
—
1160946
NCPDP PROVIDER NUMBER
—
Enumeration date
01/19/2011
Last updated
08/10/2011
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