Healthcare Provider Details

I. General information

NPI: 1891300364
Provider Name (Legal Business Name): HANFORD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 12/11/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 CAMPUS DR STE 101
HANFORD CA
93230-4374
US

IV. Provider business mailing address

365 CAMPUS DR STE 101
HANFORD CA
93230-4374
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-1480
  • Fax: 559-583-1475
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EMAD MOUSAD
Title or Position: PHARMACIST
Credential: RPH
Phone: 559-583-1480