Provider Demographics
NPI:1467667782
Name:HARRISON, JOAN B (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:B
Last Name:HARRISON
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 1:287 POKEBERRY RD
Mailing Address - Street 2:
Mailing Address - City:SADIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40370-9585
Mailing Address - Country:US
Mailing Address - Phone:502-857-4593
Mailing Address - Fax:
Practice Address - Street 1:TOYOTA FAMILY PHARMACY
Practice Address - Street 2:1001 CHERRY BLOSSOM WAY
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324
Practice Address - Country:US
Practice Address - Phone:502-570-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist