Provider Demographics
NPI:1942578851
Name:HEMOND, LISA W (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:W
Last Name:HEMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34909 EMERALD COAST PKWY
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-3446
Mailing Address - Country:US
Mailing Address - Phone:850-974-2317
Mailing Address - Fax:850-897-4199
Practice Address - Street 1:34909 EMERALD COAST PKWY
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3446
Practice Address - Country:US
Practice Address - Phone:850-974-2317
Practice Address - Fax:850-897-4199
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0028736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist