Provider Demographics
NPI:1386902633
Name:HARRIS, FRANK D III (PHARMACIST)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:D
Last Name:HARRIS
Suffix:III
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PRISON RD
Mailing Address - Street 2:FOLSOM STATE PRISON - PHARMACY
Mailing Address - City:REPRESA
Mailing Address - State:CA
Mailing Address - Zip Code:95671-4071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 PRISON RD
Practice Address - Street 2:FOLSOM STATE PRISON - PHARMACY
Practice Address - City:REPRESA
Practice Address - State:CA
Practice Address - Zip Code:95671-4071
Practice Address - Country:US
Practice Address - Phone:916-985-2561
Practice Address - Fax:916-608-3112
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist