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NPI Code Detail

MEDICARE: MONTE L HARRIS RPH

MEDICARE:   MONTE L HARRIS  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist52924CA

General Provider Information

NPI Number : 1063732139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONTE L HARRIS RPH
Provider Business Mailing Address
First Line : 1411 KETTNER BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-2420
Country : US
Telephone Number : 619-231-7405
Fax Number : 619-237-8873
Provider Business Practice Location Address
First Line : 1411 KETTNER BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-2420
Country : US
Telephone Number : 619-231-7405
Fax Number : 619-237-8873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2010
Last Update Date : 06/10/2010

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Directions to “ MONTE L HARRIS RPH” Practice Location

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