Provider Demographics
NPI:1750487989
Name:HANSEN, JEFFREY ELDEN (RPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ELDEN
Last Name:HANSEN
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 1:2017 TWIN FLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8024
Mailing Address - Country:US
Mailing Address - Phone:614-539-3938
Mailing Address - Fax:
Practice Address - Street 1:5965 HOOVER RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9702
Practice Address - Country:US
Practice Address - Phone:614-277-3405
Practice Address - Fax:614-277-6404
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033238311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist