Provider Demographics
NPI:1376714352
Name:HARLE, LISA FLOYD (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:FLOYD
Last Name:HARLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 RIVERS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7072
Mailing Address - Country:US
Mailing Address - Phone:843-745-8635
Mailing Address - Fax:843-747-6841
Practice Address - Street 1:3725 RIVERS AVE STE 2
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7072
Practice Address - Country:US
Practice Address - Phone:843-745-8635
Practice Address - Fax:843-747-6841
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC007448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist