MEDICARE: MRS. LISA THOMPSON HARRISON 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
1	183500000X	Pharmacist	13769	AL

General Provider Information

NPI Number	:	1871643098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA THOMPSON HARRISON RPH

Provider Business Mailing Address
First Line	:	9125 BERRINGTON PL
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-8479
Country	:	US
Telephone Number	:	334-651-2093
Fax Number	:	334-271-5724

Provider Business Practice Location Address
First Line	:	3881 ATLANTA HWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109-3633
Country	:	US
Telephone Number	:	334-271-5174
Fax Number	:	334-271-5724

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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