Provider Demographics
NPI:1659701662
Name:HASSLER, GENA D (RPH)
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:D
Last Name:HASSLER
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 476
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37381-0476
Mailing Address - Country:US
Mailing Address - Phone:423-365-9202
Mailing Address - Fax:423-365-5199
Practice Address - Street 1:401 FRONT ST
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-5197
Practice Address - Country:US
Practice Address - Phone:423-365-9202
Practice Address - Fax:423-365-5199
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist