Robert McCants Harris III, RPH
Individual provider Active NPI Pharmacist · Bowdon, GA
NPI 1043685779 · NPPES record last updated Dec 7, 2015
Key facts
- NPI
- 1043685779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 011265 (GA)
- Practice address
- 128 Lovvorn Ave
Bowdon, GA 30108-1141 - Phone
- (770) 258-3310
- Fax
- (770) 258-7474
- NPI assigned
- Dec 7, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011265 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011265 | GA | Yes |
Addresses
Primary practice location
128 Lovvorn Ave
Bowdon, GA 30108-1141
Mailing address
128 Lovvorn Ave
Bowdon, GA 30108-1141
Phone (770) 258-3310
Other names
- Mr. Robert McCants Harris III
Other providers in Bowdon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.