Provider Demographics
NPI:1184807109
Name:HEMPHILL, DONALD H JR (RPH, MBA)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:HEMPHILL
Suffix:JR
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 TANNERY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2655
Mailing Address - Country:US
Mailing Address - Phone:207-831-3645
Mailing Address - Fax:
Practice Address - Street 1:15 TANNERY BROOK RD
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2655
Practice Address - Country:US
Practice Address - Phone:207-831-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4243183500000X
NH2679183500000X
CT7415183500000X
FLPS 28481183500000X
VT033-0003321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist