Provider Demographics
NPI:1124393533
Name:BANH, LINDA M (RPH)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:BANH
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 1:11 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1014
Mailing Address - Country:US
Mailing Address - Phone:978-750-4334
Mailing Address - Fax:978-750-4897
Practice Address - Street 1:11 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1014
Practice Address - Country:US
Practice Address - Phone:978-750-4334
Practice Address - Fax:978-750-4897
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist