Provider Demographics
NPI:1851517866
Name:HARPER, FRED STEVEN (RPH)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:STEVEN
Last Name:HARPER
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 1175
Mailing Address - Street 2:
Mailing Address - City:SPRINGERVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:85938-1175
Mailing Address - Country:US
Mailing Address - Phone:928-333-5362
Mailing Address - Fax:928-333-5408
Practice Address - Street 1:106 E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:SPRINGERVILLE
Practice Address - State:AZ
Practice Address - Zip Code:85938
Practice Address - Country:US
Practice Address - Phone:928-333-4321
Practice Address - Fax:928-333-5408
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist