Provider Demographics
NPI:1568748150
Name:HANNA, MICHEL W (RPH)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:W
Last Name:HANNA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-1141 PANANA ST APT 1402
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3741
Mailing Address - Country:US
Mailing Address - Phone:808-391-4522
Mailing Address - Fax:808-488-7505
Practice Address - Street 1:92-1141 PANANA ST APT 1402
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-3741
Practice Address - Country:US
Practice Address - Phone:808-391-4522
Practice Address - Fax:808-488-7505
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist