Provider Demographics
NPI:1629786793
Name:HARMON, GREGORY C (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:C
Last Name:HARMON
Suffix:
Gender:M
Credentials:PHARMACIST
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 610 59-3877 AKONI PULE HWY
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755
Mailing Address - Country:US
Mailing Address - Phone:808-938-0773
Mailing Address - Fax:808-889-0180
Practice Address - Street 1:54-3877 AKONI PULE HWY
Practice Address - Street 2:
Practice Address - City:KAPAAU
Practice Address - State:HI
Practice Address - Zip Code:96755
Practice Address - Country:US
Practice Address - Phone:808-889-6161
Practice Address - Fax:808-889-0180
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-1624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist