Provider Demographics
NPI:1649337619
Name:HARMON, HEIDI GRILL (RPH)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:GRILL
Last Name:HARMON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18811 CORAL GROVE TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5386
Mailing Address - Country:US
Mailing Address - Phone:301-972-9523
Mailing Address - Fax:
Practice Address - Street 1:1 PRESERVE PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4272
Practice Address - Country:US
Practice Address - Phone:240-429-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207122183500000X
CT5505183500000X
MD10440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist