J H Harvey Co LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

J H HARVEY CO LLC

Doing business as

Harveys Supermarket Pharmacy #2310

Practice address

4036 Bemiss Rd
Valdosta, GA 31605-7847

Phone

(229) 247-5373

Fax

(229) 247-9421

NPI assigned

Aug 27, 2006

Last updated

Mar 11, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Courtney Fairbanks

Title

Pharmacy Insurance Specialist

Phone

(207) 885-7454

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Harveys Supermarket Pharmacy #2310 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1740398114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MS3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "207-396-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 BEMISS RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057847",
            "telephone_number": "229-247-5373",
            "fax_number": "229-247-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J H HARVEY CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "PHARMACY INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1152913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430067814A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harveys Supermarket Pharmacy #2310",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2309)
• Courtney Tamara Jackson, NP
• David Ray Jackson, NP
• Dorothy L Jackson
• Ginger D Jackson, PTA
• Jermika L Jackson, RBT

• Community/Retail Pharmacy in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.