Healthcare Provider Details

I. General information

NPI: 1699603332
Provider Name (Legal Business Name): HARVEY HOFFENBLUM RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 HIGHVIEW RD
TRAVERSE CITY MI
49696-8142
US

IV. Provider business mailing address

246 HIGHVIEW RD
TRAVERSE CITY MI
49696-8142
US

V. Phone/Fax

Practice location:
  • Phone: 248-390-3068
  • Fax:
Mailing address:
  • Phone: 248-390-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302022583
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: