Provider Demographics
NPI:1689657447
Name:HANNA JR., HARVEY C (RPH)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:C
Last Name:HANNA JR.
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 1:153 E STREETSBORO ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-3069
Mailing Address - Country:US
Mailing Address - Phone:330-650-6769
Mailing Address - Fax:
Practice Address - Street 1:116 W STREETSBORO ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2756
Practice Address - Country:US
Practice Address - Phone:330-650-1608
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03108930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist