MEDICARE: JAMES ALEXANDER HARRIS R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH009308	GA

General Provider Information

NPI Number	:	1164522843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALEXANDER HARRIS R.PH.

Provider Business Mailing Address
First Line	:	4839 BLOOMFIELD RD
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31206-4307
Country	:	US
Telephone Number	:	478-781-1213
Fax Number	:	478-788-9078

Provider Business Practice Location Address
First Line	:	4839 BLOOMFIELD RD
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31206-4307
Country	:	US
Telephone Number	:	478-781-1213
Fax Number	:	478-788-9078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/08/2007

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