Provider Demographics
NPI:1891739967
Name:HOFSTAEDTER, PAUL GERARD (RPH,BSC,PHG)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GERARD
Last Name:HOFSTAEDTER
Suffix:
Gender:M
Credentials:RPH,BSC,PHG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 EASTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LANDISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17538-1573
Mailing Address - Country:US
Mailing Address - Phone:717-898-9338
Mailing Address - Fax:
Practice Address - Street 1:241 W ROSEVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3100
Practice Address - Country:US
Practice Address - Phone:717-569-0825
Practice Address - Fax:717-509-4960
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034465L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist