Healthcare Provider Details

I. General information

NPI: 1972122349
Provider Name (Legal Business Name): HARRP GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 GLORIA DR
MOSS BLUFF LA
70611-5043
US

IV. Provider business mailing address

114 GLORIA DR
MOSS BLUFF LA
70611-5043
US

V. Phone/Fax

Practice location:
  • Phone: 337-405-7880
  • Fax: 337-405-7886
Mailing address:
  • Phone: 337-405-7880
  • Fax: 337-405-7886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL RAND PETTIT II
Title or Position: OWNER/PHARMACIST
Credential: PHARMD
Phone: 337-405-7880