Provider Demographics
NPI:1518388743
Name:GARBER, HAROLD
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:GARBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HAL
Other - Middle Name:ARTHUR
Other - Last Name:GARBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2727 E BROADWAY RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-1530
Mailing Address - Country:US
Mailing Address - Phone:480-464-4742
Mailing Address - Fax:480-644-0964
Practice Address - Street 1:2727 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1530
Practice Address - Country:US
Practice Address - Phone:480-464-4742
Practice Address - Fax:480-644-0964
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist