Healthcare Provider Details

I. General information

NPI: 1093396756
Provider Name (Legal Business Name): HANNAH PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SCOTT ST
NAPOLEON OH
43545-1054
US

IV. Provider business mailing address

1111 SCOTT ST
NAPOLEON OH
43545-1054
US

V. Phone/Fax

Practice location:
  • Phone: 419-592-9086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number09314940
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: