Provider Demographics
NPI:1659629277
Name:HANNON, CLAIRANN R (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRANN
Middle Name:R
Last Name:HANNON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CLAIR
Other - Middle Name:R
Other - Last Name:HANNON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2127 BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-3827
Mailing Address - Country:US
Mailing Address - Phone:843-524-4057
Mailing Address - Fax:843-524-1952
Practice Address - Street 1:2127 BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-3827
Practice Address - Country:US
Practice Address - Phone:843-524-4057
Practice Address - Fax:843-524-1952
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11472183500000X
GARPH023521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist