Provider Demographics
NPI:1275803819
Name:HARDY, DENIS M (RPH)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:M
Last Name:HARDY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1321
Mailing Address - Country:US
Mailing Address - Phone:805-733-2064
Mailing Address - Fax:
Practice Address - Street 1:442 SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1321
Practice Address - Country:US
Practice Address - Phone:805-733-2064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist