Healthcare Provider Details

I. General information

NPI: 1528020260
Provider Name (Legal Business Name): WILLIAM GEORGE HARMON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 JEFFERSON BARRACKS DR VA MEDICAL CENTER ST LOUIS 119JB
SAINT LOUIS MO
63125-4181
US

IV. Provider business mailing address

1936 EAGLE CRST
BARNHART MO
63012-2723
US

V. Phone/Fax

Practice location:
  • Phone: 314-652-4100
  • Fax: 314-845-5091
Mailing address:
  • Phone: 636-479-9947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29096
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: