Provider Demographics
NPI:1629099049
Name:HARRISON, LARRY ALLEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:ALLEN
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 1:2180 ABNER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-9775
Mailing Address - Country:US
Mailing Address - Phone:864-877-4180
Mailing Address - Fax:
Practice Address - Street 1:1582 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9702
Practice Address - Country:US
Practice Address - Phone:864-486-8252
Practice Address - Fax:864-486-9917
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist