Provider Demographics
NPI:1700273778
Name:TUCKER, HARRY FRANCIS (RPH)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:FRANCIS
Last Name:TUCKER
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 1:17195 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7482
Mailing Address - Country:US
Mailing Address - Phone:574-340-8727
Mailing Address - Fax:
Practice Address - Street 1:17195 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-7482
Practice Address - Country:US
Practice Address - Phone:574-340-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017861A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist