Healthcare Provider Details

I. General information

NPI: 1548684814
Provider Name (Legal Business Name): HARBOR HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 ATTUCKS LN
HYANNIS MA
02601-1867
US

IV. Provider business mailing address

735 ATTUCKS LN
HYANNIS MA
02601-1867
US

V. Phone/Fax

Practice location:
  • Phone: 508-778-5414
  • Fax: 508-778-5429
Mailing address:
  • Phone: 508-778-5414
  • Fax: 508-778-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberDS89917
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICTOR FOURNIER
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 617-533-2280