Provider Demographics
NPI:1003323957
Name:HARVEY, ANDRE CLIFFORD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:CLIFFORD
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 VICTORIA PL SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-2768
Mailing Address - Country:US
Mailing Address - Phone:404-414-5044
Mailing Address - Fax:
Practice Address - Street 1:4949 BILL GARDNER PKWY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-2910
Practice Address - Country:US
Practice Address - Phone:678-734-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist