Provider Demographics
NPI:1578883807
Name:HARRIS, CHRISTOPHER DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MONROE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010
Mailing Address - Country:US
Mailing Address - Phone:269-673-6749
Mailing Address - Fax:269-673-9491
Practice Address - Street 1:100 MONROE ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010
Practice Address - Country:US
Practice Address - Phone:269-673-6749
Practice Address - Fax:269-673-9491
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302033987OtherBOARD OF PHARMACY LICENSE NUMBER