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MRS. MARY ELLEN HANSEN RPH.
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1265594394
Individual Registrant:MRS. MARY ELLEN HANSEN RPH.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
110 LUKE AVE BOLLING AFB, MD 20032 US
Tel: 202-767-5405 Fax: --
Tel: 202-767-5405 Fax: --
Contact information for business:
7820 BELLEFLOWER DR SPRINGFIELD, VA 22152-3115 US
Tel: 703-894-8974 Fax: --
Tel: 703-894-8974 Fax: --
Registration Information:
NPI: 1265594394
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | MA | 20162 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
