Provider Demographics
NPI:1538382148
Name:HARDEN, GARY LEE (BSPHARM)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEE
Last Name:HARDEN
Suffix:
Gender:M
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 LAKEMONT DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-8326
Mailing Address - Country:US
Mailing Address - Phone:704-484-0755
Mailing Address - Fax:
Practice Address - Street 1:152 LAKEMONT DR
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-8326
Practice Address - Country:US
Practice Address - Phone:704-484-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist