Provider Demographics
NPI:1588738280
Name:MATHEWS, HARRIET V (RPH)
Entity type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:V
Last Name:MATHEWS
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:PO BOX 740
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-0740
Mailing Address - Country:US
Mailing Address - Phone:706-742-7951
Mailing Address - Fax:
Practice Address - Street 1:1220 S MILLEDGE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1446
Practice Address - Country:US
Practice Address - Phone:706-543-7386
Practice Address - Fax:706-543-8544
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist