Provider Demographics
NPI:1649588567
Name:HUI-CALLAHAN, BONNIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:HUI-CALLAHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3840
Mailing Address - Country:US
Mailing Address - Phone:937-435-6420
Mailing Address - Fax:937-439-6455
Practice Address - Street 1:1023 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3840
Practice Address - Country:US
Practice Address - Phone:937-435-6420
Practice Address - Fax:937-439-6455
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64270183500000X
OH03230708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist