Provider Demographics
NPI:1003298886
Name:HERNANDEZ, EUNICE (RPH)
Entity Type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 ROSEMARY LN
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1943
Mailing Address - Country:US
Mailing Address - Phone:240-449-6684
Mailing Address - Fax:
Practice Address - Street 1:9420 LANHAM SEVERN RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2642
Practice Address - Country:US
Practice Address - Phone:301-577-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist