Healthcare Provider Details

I. General information

NPI: 1912033382
Provider Name (Legal Business Name): GARY STEVEN HARRIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E BRANNON RD
NICHOLASVILLE KY
40356-8059
US

IV. Provider business mailing address

200 E BRANNON RD
NICHOLASVILLE KY
40356-8059
US

V. Phone/Fax

Practice location:
  • Phone: 859-971-4303
  • Fax: 859-971-4309
Mailing address:
  • Phone: 859-971-4303
  • Fax: 859-971-4309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number011554
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number011554
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number011554
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: