Provider Demographics
NPI:1841226339
Name:HARRIS BROTHERS APOTHECARIES INC
Entity Type:Organization
Organization Name:HARRIS BROTHERS APOTHECARIES INC
Other - Org Name:HARRIS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-742-8500
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-0158
Mailing Address - Country:US
Mailing Address - Phone:706-742-8500
Mailing Address - Fax:706-742-8927
Practice Address - Street 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:GA
Practice Address - Zip Code:30683-0158
Practice Address - Country:US
Practice Address - Phone:706-742-8500
Practice Address - Fax:706-742-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA40853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0516690001Medicare ID - Type Unspecified