Provider Demographics
NPI:1639216567
Name:HAJNY, MARIE LENA (RPH)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LENA
Last Name:HAJNY
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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:MT
Mailing Address - Zip Code:59729-0306
Mailing Address - Country:US
Mailing Address - Phone:406-682-4246
Mailing Address - Fax:406-682-7568
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:MT
Practice Address - Zip Code:59729-0306
Practice Address - Country:US
Practice Address - Phone:406-682-4246
Practice Address - Fax:406-682-7568
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist