Basic Information
Provider Information
NPI: 1437243474
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARP
FirstName: ANNEJANET
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1525 LORICK AVE
Address2:  
City: COLUMBIA
State: SC
PostalCode: 292035835
CountryCode: US
TelephoneNumber: 8037358475
FaxNumber: 8037517358
Practice Location
Address1: 4500 STUART ST
Address2:  
City: COLUMBIA
State: SC
PostalCode: 292075700
CountryCode: US
TelephoneNumber: 8037517358
FaxNumber: 8037517358
Other Information
ProviderEnumerationDate: 10/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X31253FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


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