Provider Demographics
NPI:1619298775
Name:HANNA, MAGDY (RPH)
Entity Type:Individual
Prefix:MR
First Name:MAGDY
Middle Name:
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 1:1610 CHURCH ST STE C
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-2960
Mailing Address - Country:US
Mailing Address - Phone:843-488-3535
Mailing Address - Fax:843-488-3435
Practice Address - Street 1:1610 CHURCH ST STE C
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-2960
Practice Address - Country:US
Practice Address - Phone:843-488-3535
Practice Address - Fax:843-488-3435
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11898183500000X
NJ28RI02710100183500000X
TX45743183500000X
SC011898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist