MEDICARE: HARRP GROUP LLC

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

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

General Provider Information

NPI Number	:	1972122349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRP GROUP LLC

Provider Business Mailing Address
First Line	:	114 GLORIA DR
Second Line	:
City	:	MOSS BLUFF
State	:	LA
Zip	:	70611-5043
Country	:	US
Telephone Number	:	337-405-7880
Fax Number	:	337-405-7886

Provider Business Practice Location Address
First Line	:	114 GLORIA DR
Second Line	:
City	:	MOSS BLUFF
State	:	LA
Zip	:	70611-5043
Country	:	US
Telephone Number	:	337-405-7880
Fax Number	:	337-405-7886

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MR. MICHAEL RAND PETTIT II
Credential	:	PHARMD
Telephone Number	:	337-405-7880

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	06/16/2025

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