Basic Information
Provider Information
NPI: 1528694874
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARSH
FirstName: THOMAS
MiddleName: ALLAN
NamePrefix:  
NameSuffix:  
Credential: PHARM D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 739 PARK ST
Address2:  
City: CUMBERLAND
State: MD
PostalCode: 215023172
CountryCode: US
TelephoneNumber: 3017777670
FaxNumber:  
Practice Location
Address1: 739 PARK ST
Address2:  
City: CUMBERLAND
State: MD
PostalCode: 215023172
CountryCode: US
TelephoneNumber: 3017777670
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/18/2020
LastUpdateDate: 03/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P0018XRP0007400MDY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

No ID Information.


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