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NPI Code Detail

MEDICARE: MRS. MALLORY HARRIS PHARMD

MEDICARE: MRS. MALLORY HARRIS PHARMD
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
1183500000XPharmacistE-14921MS

General Provider Information

NPI Number : 1447897491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MALLORY HARRIS PHARMD
Provider Business Mailing Address
First Line : 6745 S SIWELL RD
Second Line :
City : BYRAM
State : MS
Zip : 39272-8747
Country : US
Telephone Number : 601-863-2006
Fax Number :
Provider Business Practice Location Address
First Line : 6745 S SIWELL RD
Second Line :
City : BYRAM
State : MS
Zip : 39272-8747
Country : US
Telephone Number : 601-863-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 12/09/2019

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