Healthcare Provider Details

I. General information

NPI: 1891739967
Provider Name (Legal Business Name): PAUL GERARD HOFSTAEDTER RPH,BSC,PHG
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 W ROSEVILLE RD
LANCASTER PA
17601-3100
US

IV. Provider business mailing address

699 EASTSIDE DR
LANDISVILLE PA
17538-1573
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-0825
  • Fax: 717-509-4960
Mailing address:
  • Phone: 717-898-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034465L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: