Provider Demographics
NPI:1982837795
Name:D&S HAULMAN ENTERPRISES LLC
Entity Type:Organization
Organization Name:D&S HAULMAN ENTERPRISES LLC
Other - Org Name:MOUNTAIN VIEW PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-748-3196
Mailing Address - Street 1:144 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RENOVO
Mailing Address - State:PA
Mailing Address - Zip Code:17764-1071
Mailing Address - Country:US
Mailing Address - Phone:570-923-1922
Mailing Address - Fax:
Practice Address - Street 1:144 4TH ST
Practice Address - Street 2:
Practice Address - City:RENOVO
Practice Address - State:PA
Practice Address - Zip Code:17764-1071
Practice Address - Country:US
Practice Address - Phone:570-923-1922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4819413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2121724OtherPK