Provider Demographics
NPI:1598574402
Name:HARRIS, JEFFREY P (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:HARRIS
Suffix:
Gender:M
Credentials:RPH, PHARMD
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 762
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:WY
Mailing Address - Zip Code:82331-0762
Mailing Address - Country:US
Mailing Address - Phone:307-275-6144
Mailing Address - Fax:
Practice Address - Street 1:602 N HIGLEY BLVD
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5968
Practice Address - Country:US
Practice Address - Phone:307-324-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist