Healthcare Provider Details

I. General information

NPI: 1508973884
Provider Name (Legal Business Name): HANOVER HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CARLISLE ST
HANOVER PA
17331-1703
US

IV. Provider business mailing address

800 CARLISLE ST
HANOVER PA
17331
US

V. Phone/Fax

Practice location:
  • Phone: 717-637-4003
  • Fax: 717-337-2746
Mailing address:
  • Phone: 717-637-4003
  • Fax: 717-334-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPP415193L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONA RENEE LASLOW
Title or Position: OWNER PHARMASIST
Credential: RPH
Phone: 717-337-0881