Provider Demographics
NPI:1730699638
Name:HARRIS, PAIGE LEIGH (RPH)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:LEIGH
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 1:950 S ROUTE O
Mailing Address - Street 2:
Mailing Address - City:ROCHEPORT
Mailing Address - State:MO
Mailing Address - Zip Code:65279-9471
Mailing Address - Country:US
Mailing Address - Phone:573-424-2998
Mailing Address - Fax:
Practice Address - Street 1:551 E SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-4236
Practice Address - Country:US
Practice Address - Phone:573-882-3151
Practice Address - Fax:573-884-5022
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO041833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist