Provider Demographics
NPI:1962613166
Name:HARCHANKO, JOSEPH RAY (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RAY
Last Name:HARCHANKO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-2357
Mailing Address - Country:US
Mailing Address - Phone:507-376-5555
Mailing Address - Fax:
Practice Address - Street 1:225 10TH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2357
Practice Address - Country:US
Practice Address - Phone:507-376-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist