Healthcare Provider Details

I. General information

NPI: 1255265609
Provider Name (Legal Business Name): BERHANU YOHANNES HANFORE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MALORE YOHANNES HANFORE

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SANGERS LN
STAUNTON VA
24401-6712
US

IV. Provider business mailing address

85 SANGERS LN
STAUNTON VA
24401-6712
US

V. Phone/Fax

Practice location:
  • Phone: 267-231-9059
  • Fax: 540-435-1888
Mailing address:
  • Phone: 267-231-9059
  • Fax: 540-435-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number0202209095
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: