Provider Demographics
NPI:1790418598
Name:HASSEY, AVERY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:AVERY
Middle Name:ANN
Last Name:HASSEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SLOCUM AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1201
Mailing Address - Country:US
Mailing Address - Phone:570-855-5946
Mailing Address - Fax:
Practice Address - Street 1:104 SLOCUM AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1201
Practice Address - Country:US
Practice Address - Phone:570-855-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL642491835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist