MEDICARE: MR. WILLIAM H HENNING R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	RP042957L	PA

General Provider Information

NPI Number	:	1639327588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM H HENNING R.PH.

Provider Business Mailing Address
First Line	:	2245 SNYDERTOWN RD
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17821-7615
Country	:	US
Telephone Number	:	570-271-6672
Fax Number	:

Provider Business Practice Location Address
First Line	:	GEISINGER MEDICAL CENTER INPATIENT PHARMACY
Second Line	:	100 N ACADEMY AVE
City	:	DANVILLE
State	:	PA
Zip	:	17822-0001
Country	:	US
Telephone Number	:	570-271-6672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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