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MRS. MARY ELLEN HANSEN RPH.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1265594394

Individual Registrant:
MRS. MARY ELLEN HANSEN RPH.
Gender: F
Sole Proprietor

Location and contact information for practice:
110 LUKE AVE  BOLLING AFB, MD 20032 US
Tel: 202-767-5405  Fax: --

Contact information for business:
7820 BELLEFLOWER DR  SPRINGFIELD, VA 22152-3115 US
Tel: 703-894-8974  Fax: --

Registration Information:
NPI: 1265594394
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MA20162

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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