Provider Demographics
NPI:1346508066
Name:HOFFMAN, MONTE
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONTE
Other - Middle Name:
Other - Last Name:LITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:228 SUZANNE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26181-3541
Mailing Address - Country:US
Mailing Address - Phone:304-483-2987
Mailing Address - Fax:
Practice Address - Street 1:4016 OHIO RIVER RD
Practice Address - Street 2:
Practice Address - City:PT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-3257
Practice Address - Country:US
Practice Address - Phone:304-675-1612
Practice Address - Fax:304-675-7338
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist