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General NPI Number Information
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NPI Number | 1174624324
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Entity Type | Organization
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Legal Business Name | J & H PHARMACY INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 1465 N WESTWOOD BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-3315
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Country | US
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Telephone | 573-785-0127
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Fax | 573-785-1209
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Provider Business Mailing Address
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Address Line | 1465 N WESTWOOD BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-3315
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Country | US
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Telephone | 573-785-0127
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Fax | 573-785-1209
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Authorized Official
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Title or Position | OWNER
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Name | JAMES I HARLAN III
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Credential |
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Telephone | 573-785-0127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30097
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5992
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License Number State | MO
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