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General NPI Number Information
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NPI Number | 1457787954
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Entity Type | Individual
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Provider Name | TEAL MARIE HARVEY PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 12775 HONCUT RD
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City | LOMA RICA
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State | CA
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Zip | 95901-9122
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Country | US
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Telephone | 530-713-1965
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1712
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City | MARYSVILLE
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State | CA
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Zip | 95901-0050
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Country | US
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Telephone | 530-713-1965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 67281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 67281
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License Number State | CA
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