Provider Demographics
NPI:1972122349
Name:HARRP GROUP
Entity type:Organization
Organization Name:HARRP GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAND
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:II
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:337-405-7880
Mailing Address - Street 1:114 GLORIA DR
Mailing Address - Street 2:
Mailing Address - City:MOSS BLUFF
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5043
Mailing Address - Country:US
Mailing Address - Phone:337-405-7880
Mailing Address - Fax:337-405-7886
Practice Address - Street 1:114 GLORIA DR
Practice Address - Street 2:
Practice Address - City:MOSS BLUFF
Practice Address - State:LA
Practice Address - Zip Code:70611-5043
Practice Address - Country:US
Practice Address - Phone:337-314-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy