1609976919 NPI number — HARRINGTONS PHARMACY NO 2

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609976919 NPI number — HARRINGTONS PHARMACY NO 2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRINGTONS PHARMACY NO 2
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609976919
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5400 RUSTIC TRL
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
COLLEYVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76034-3242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1750 SW HEALTH PKWY
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34109-0420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-592-5147
Provider Business Practice Location Address Fax Number:
239-592-5671
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MYLER
Authorized Official First Name:
SUSANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP CHAIN COMPLIANCE OPS
Authorized Official Telephone Number:
817-503-8880

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PH22144 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1009605 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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