Provider Demographics
NPI:1558854687
Name:HARRIS, MARGARET ANN WILKES (RPH)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN WILKES
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:WILKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2185 STATION VILLAGE WAY APT 2227
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-6524
Mailing Address - Country:US
Mailing Address - Phone:734-968-8916
Mailing Address - Fax:
Practice Address - Street 1:2185 STATION VILLAGE WAY APT 2227
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-6524
Practice Address - Country:US
Practice Address - Phone:734-968-8916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist