MEDICARE: HARPERSVILLE PHARMACY

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
1	3336C0003X	Community/Retail Pharmacy	112982	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1996167	OTHER		PK

General Provider Information

NPI Number	:	1346434537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARPERSVILLE PHARMACY

Provider Business Mailing Address
First Line	:	39321 HIGHWAY 25
Second Line	:	SUITE 100
City	:	HARPERSVILLE
State	:	AL
Zip	:	35078-4949
Country	:	US
Telephone Number	:	205-642-9222
Fax Number	:	205-642-9224

Provider Business Practice Location Address
First Line	:	39321 HIGHWAY 25
Second Line	:
City	:	HARPERSVILLE
State	:	AL
Zip	:	35078-4949
Country	:	US
Telephone Number	:	205-642-9222
Fax Number	:	205-642-9224

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL DEICHMANN
Credential	:	PHRMD
Telephone Number	:	205-642-9300

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	05/16/2014

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Directions to “HARPERSVILLE PHARMACY ” Practice Location

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