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General NPI Number Information
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NPI Number | 1750499125
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Entity Type | Organization
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Legal Business Name | J H HARVEY CO LLC
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 5010 W TENNESSEE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32304-3554
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Country | US
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Telephone | 850-575-2380
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Fax | 850-575-3047
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Provider Business Mailing Address
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Address Line | PO BOX 1000
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City | PORTLAND
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State | ME
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Zip | 04104-5005
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Country | US
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Telephone | 207-885-3161
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Fax | 207-885-3121
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | ROY WILSON
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Credential |
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Telephone | 229-686-9411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PH21683
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License Number State | FL
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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 | PH21683
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License Number State | FL
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