Organization
J.H. HARVEYS CO.
Active
Other names
Harveys Supermarket Pharmacy #2346
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FAIRBANKS (PHARMACY INSURANCE SPECIALIST)
(207) 885-7454
Entity
Organization
Contact information
Practice address
1011 E 16TH AVE, CORDELE, GA 31015-1539
(229) 273-8231
(229) 273-8273
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
PHRE009073
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154931
NCPDP
GA
05
—
430067814C
—
GA
Enumeration date
09/22/2006
Last updated
03/11/2011
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