Provider Demographics
NPI:1770806697
Name:HARVEY, THERESE A (RPH)
Entity type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:A
Last Name:HARVEY
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 1:789 SPRUCE ST
Mailing Address - Street 2:PO BOX 173
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-1459
Mailing Address - Country:US
Mailing Address - Phone:724-847-0707
Mailing Address - Fax:
Practice Address - Street 1:300 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-2165
Practice Address - Country:US
Practice Address - Phone:724-775-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028999L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist