Provider Demographics
NPI:1962434290
Name:HARLAN, JAMES I (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:I
Last Name:HARLAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14100 ALAN DR
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-9755
Mailing Address - Country:US
Mailing Address - Phone:573-686-3634
Mailing Address - Fax:573-785-1209
Practice Address - Street 1:1465 N WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3315
Practice Address - Country:US
Practice Address - Phone:573-785-0127
Practice Address - Fax:573-785-1209
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO30097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist