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NPI Code Detail

MEDICARE: KEVIN HARRISON PHARM.D, RPH

MEDICARE:   KEVIN  HARRISON  PHARM.D, 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
1183500000XPharmacistPR12506ME

General Provider Information

NPI Number : 1730433459
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN HARRISON PHARM.D, RPH
Provider Business Mailing Address
First Line : 127 MARGINAL WAY
Second Line :
City : PORTLAND
State : ME
Zip : 04101-2470
Country : US
Telephone Number : 207-771-5631
Fax Number :
Provider Business Practice Location Address
First Line : 127 MARGINAL WAY
Second Line :
City : PORTLAND
State : ME
Zip : 04101-2470
Country : US
Telephone Number : 207-771-5631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2012
Last Update Date : 11/02/2012

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Directions to “ KEVIN HARRISON PHARM.D, RPH” Practice Location

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