Provider Demographics
NPI:1508973884
Name:HANOVER HOME HEALTH, INC.
Entity Type:Organization
Organization Name:HANOVER HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMASIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LASLOW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-337-0881
Mailing Address - Street 1:800 CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-637-4003
Mailing Address - Fax:717-334-2647
Practice Address - Street 1:800 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1703
Practice Address - Country:US
Practice Address - Phone:717-637-4003
Practice Address - Fax:717-337-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415193L183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015978980001Medicaid
0736110001Medicare NSC