Provider Demographics
NPI:1679591150
Name:HARMS, BRAD J (RPH)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:J
Last Name:HARMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-4288
Mailing Address - Country:US
Mailing Address - Phone:319-277-1829
Mailing Address - Fax:319-277-1870
Practice Address - Street 1:103 E 18TH ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-4288
Practice Address - Country:US
Practice Address - Phone:319-277-1829
Practice Address - Fax:319-277-1870
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA17251OtherIOWA RPH LICENCE NUMBER