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General NPI Number Information
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NPI Number | 1780284000
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Entity Type | Individual
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Provider Name | CAMERON KYLE HARRINGTON
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2705 S GRAND AVE
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City | CARTHAGE
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State | MO
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Zip | 64836-7907
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Country | US
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Telephone | 417-358-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 2824 W 23RD TER
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City | JOPLIN
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State | MO
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Zip | 64804-0218
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Country | US
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Telephone | 417-389-6646
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2019047132
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License Number State | MO
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