Provider Demographics
NPI:1528020260
Name:HARMON, WILLIAM GEORGE (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:HARMON
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 1:1936 EAGLE CRST
Mailing Address - Street 2:
Mailing Address - City:BARNHART
Mailing Address - State:MO
Mailing Address - Zip Code:63012-2723
Mailing Address - Country:US
Mailing Address - Phone:636-479-9947
Mailing Address - Fax:
Practice Address - Street 1:2 JEFFERSON BARRACKS DR
Practice Address - Street 2:VA MEDICAL CENTER ST LOUIS 119JB
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4181
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-845-5091
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO29096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist