=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841520871
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA F HARRISON PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2010
-----------------------------------------------------
Last Update Date | 01/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1253 DIX AVE CVS #2685
-----------------------------------------------------
City | HUDSON FALLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12839-9618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-747-4786
-----------------------------------------------------
Fax | 518-747-2974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1253 DIX AVE CVS #2685
-----------------------------------------------------
City | HUDSON FALLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12839-9618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-747-4786
-----------------------------------------------------
Fax | 518-747-2974
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 050337
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------