Provider Demographics
NPI:1225368582
Name:HARRIS, RICHARD LYNN (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LYNN
Last Name:HARRIS
Suffix:
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 1:2483 E FLORENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85194-5429
Mailing Address - Country:US
Mailing Address - Phone:520-836-1185
Mailing Address - Fax:520-836-5161
Practice Address - Street 1:2483 E FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85194-5429
Practice Address - Country:US
Practice Address - Phone:520-836-1185
Practice Address - Fax:520-836-5161
Is Sole Proprietor?:No
Enumeration Date:2010-01-10
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist