Provider Demographics
NPI:1629161542
Name:HARSHBARGER, DEBORAH KAY
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:KAY
Last Name:HARSHBARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6975 PLACEWAY ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9704
Mailing Address - Country:US
Mailing Address - Phone:517-787-8921
Mailing Address - Fax:
Practice Address - Street 1:2251 SPRINGPORT RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1496
Practice Address - Country:US
Practice Address - Phone:517-768-1492
Practice Address - Fax:517-768-9093
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist