Provider Demographics
NPI:1790091684
Name:BANKS, HANNA M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HANNA
Middle Name:M
Last Name:BANKS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2240
Mailing Address - Country:US
Mailing Address - Phone:504-341-2711
Mailing Address - Fax:504-341-2999
Practice Address - Street 1:4000 4TH ST
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2240
Practice Address - Country:US
Practice Address - Phone:504-341-2711
Practice Address - Fax:504-341-2999
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist