Provider Demographics
NPI:1205819562
Name:HARMON, IRVIN STACK JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:IRVIN
Middle Name:STACK
Last Name:HARMON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 SCARBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3665
Mailing Address - Country:US
Mailing Address - Phone:864-968-0153
Mailing Address - Fax:
Practice Address - Street 1:32 S MAIN ST
Practice Address - Street 2:MCLESKEY TODD PHARMACY OF TRAVELERS REST
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1810
Practice Address - Country:US
Practice Address - Phone:864-834-4678
Practice Address - Fax:864-834-4614
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist