Provider Demographics
NPI:1891300364
Name:HANFORD PHARMACY INC
Entity Type:Organization
Organization Name:HANFORD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:559-583-1480
Mailing Address - Street 1:365 CAMPUS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:365 CAMPUS DR STE 101
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4374
Practice Address - Country:US
Practice Address - Phone:559-583-1480
Practice Address - Fax:559-583-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy