MEDICARE: DR. DEBRA KAYE 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
1	183500000X	Pharmacist	RP0007390	WV
2	183500000X	Pharmacist	010793	KY
3	183500000X	Pharmacist	PS40930	FL
4	183500000X	Pharmacist	051293224	IL

General Provider Information

NPI Number	:	1760775183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA KAYE HARRIS PHARMD

Provider Business Mailing Address
First Line	:	1051 NEWTOWN PIKE STE 160
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1245
Country	:	US
Telephone Number	:	859-226-0585
Fax Number	:	859-226-0595

Provider Business Practice Location Address
First Line	:	1051 NEWTOWN PIKE STE 160
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1245
Country	:	US
Telephone Number	:	859-226-0585
Fax Number	:	859-226-0595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	05/18/2011

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