Provider Demographics
NPI:1013309970
Name:MAHEW, HARRY RICHARD JR (RPH)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:RICHARD
Last Name:MAHEW
Suffix:JR
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 1:6818 REGENTS VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-1506
Mailing Address - Country:US
Mailing Address - Phone:813-624-2488
Mailing Address - Fax:
Practice Address - Street 1:4445 STATE ROAD 674
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5369
Practice Address - Country:US
Practice Address - Phone:813-633-9695
Practice Address - Fax:813-633-6641
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist