Provider Demographics
NPI:1487663803
Name:DENSMAN, HAL J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:J
Last Name:DENSMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 LODGEPOLE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-9123
Mailing Address - Country:US
Mailing Address - Phone:850-683-1111
Mailing Address - Fax:
Practice Address - Street 1:1116 N FERDON BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-1710
Practice Address - Country:US
Practice Address - Phone:850-683-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist