Provider Demographics
NPI:1659553279
Name:HANFORD, DAVID B (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:HANFORD
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 1:33 TWINS RD
Mailing Address - Street 2:
Mailing Address - City:PENNELLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13132-3174
Mailing Address - Country:US
Mailing Address - Phone:315-695-2529
Mailing Address - Fax:
Practice Address - Street 1:33 TWINS RD
Practice Address - Street 2:
Practice Address - City:PENNELLVILLE
Practice Address - State:NY
Practice Address - Zip Code:13132-3174
Practice Address - Country:US
Practice Address - Phone:315-695-2529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist