Provider Demographics
NPI:1689755324
Name:HARDIN, HOWARD DANIEL (RPH, MBA)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:DANIEL
Last Name:HARDIN
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12157 MORESTEAD CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7071
Mailing Address - Country:US
Mailing Address - Phone:804-364-0494
Mailing Address - Fax:
Practice Address - Street 1:12157 MORESTEAD CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-7071
Practice Address - Country:US
Practice Address - Phone:804-364-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202008047183500000X
NC07350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07350OtherPHARMACISTS REGISTRATION
VA0202008047OtherPHARMACISTS REGISTRATION