Provider Demographics
NPI:1427658897
Name:HARRIS, LORAINE MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LORAINE
Middle Name:MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5142 OAKHILL ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9516
Mailing Address - Country:US
Mailing Address - Phone:330-418-4384
Mailing Address - Fax:
Practice Address - Street 1:4572 MEGA ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7098
Practice Address - Country:US
Practice Address - Phone:330-305-0037
Practice Address - Fax:330-305-6711
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist