Basic Information
Provider Information
NPI: 1104095447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARSCH
FirstName: ANDREA
MiddleName: HELENANN
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/20/2008
LastUpdateDate: 08/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPS 36589FLY Pharmacy Service ProvidersPharmacist 
183500000XPH-2535HIN Pharmacy Service ProvidersPharmacist 

No ID Information.


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