Provider Demographics
NPI:1093888901
Name:HATCH, VIRGIL VERNON (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:VIRGIL
Middle Name:VERNON
Last Name:HATCH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2334
Mailing Address - Country:US
Mailing Address - Phone:308-762-1431
Mailing Address - Fax:
Practice Address - Street 1:312 FLACK AVE.
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301
Practice Address - Country:US
Practice Address - Phone:308-762-4451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist