Provider Demographics
NPI:1033377619
Name:HARRINGTON, BOBBY LEE
Entity Type:Individual
Prefix:
First Name:BOBBY
Middle Name:LEE
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 FALMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3269
Mailing Address - Country:US
Mailing Address - Phone:248-879-6233
Mailing Address - Fax:
Practice Address - Street 1:1301 W 14 MILE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-2803
Practice Address - Country:US
Practice Address - Phone:248-435-2410
Practice Address - Fax:248-435-4538
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist