Provider Demographics
NPI:1285863688
Name:CHARLOTTE HANNA
Entity Type:Organization
Organization Name:CHARLOTTE HANNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-793-2794
Mailing Address - Street 1:2 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:N WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04061-4401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:N WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04061-4401
Practice Address - Country:US
Practice Address - Phone:207-793-2794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care