Provider Demographics
NPI:1316374143
Name:ONE HANSON PHARMACY AND WELLNESS CENTER
Entity Type:Organization
Organization Name:ONE HANSON PHARMACY AND WELLNESS CENTER
Other - Org Name:ONE HANSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DARFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:571-285-1784
Mailing Address - Street 1:3286 OLD BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192
Mailing Address - Country:US
Mailing Address - Phone:571-285-1784
Mailing Address - Fax:571-285-1958
Practice Address - Street 1:3286 OLD BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192
Practice Address - Country:US
Practice Address - Phone:571-285-1784
Practice Address - Fax:571-285-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-13
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7251150001Medicare NSC