=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295017515
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELE HARMS RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2011
-----------------------------------------------------
Last Update Date | 09/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1999 GRAND AVE
-----------------------------------------------------
City | WEST DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50265-4223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-222-1546
-----------------------------------------------------
Fax | 515-222-0724
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1070 50TH ST #8A
-----------------------------------------------------
City | WEST DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50266-4985
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-224-0431
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 15280
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------