Provider Demographics
NPI:1538574306
Name:HARKNESS, JOHN C (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:HARKNESS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:#10001
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5247
Mailing Address - Fax:612-262-5375
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:#10001
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:612-262-5247
Practice Address - Fax:612-262-5375
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN115023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN115023OtherSTATE BOARD OF PHARMACY