Provider Demographics
NPI:1558822262
Name:CERIC, HANA (RPH)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:CERIC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 BLUE DIAMOND RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-9298
Mailing Address - Country:US
Mailing Address - Phone:702-614-4331
Mailing Address - Fax:702-614-4322
Practice Address - Street 1:7975 BLUE DIAMOND RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-9298
Practice Address - Country:US
Practice Address - Phone:702-614-4331
Practice Address - Fax:702-614-4322
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist