Provider Demographics
NPI:1609925676
Name:HARRISON, REX EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:EUGENE
Last Name:HARRISON
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:PO BOX 339
Mailing Address - Street 2:25372 HIGHWAY 195
Mailing Address - City:DOUBLE SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:35553-0339
Mailing Address - Country:US
Mailing Address - Phone:205-489-8806
Mailing Address - Fax:205-489-8422
Practice Address - Street 1:25372 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553-0339
Practice Address - Country:US
Practice Address - Phone:205-489-8806
Practice Address - Fax:205-489-8422
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11164183500000X
TN6871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist