Provider Demographics
NPI:1205349263
Name:HARMON, ANDREW ALLEN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ALLEN
Last Name:HARMON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 STAYMAN DR
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-3883
Mailing Address - Country:US
Mailing Address - Phone:304-270-0380
Mailing Address - Fax:
Practice Address - Street 1:436 RETAIL COMMONS PKWY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-6183
Practice Address - Country:US
Practice Address - Phone:304-264-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist