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General NPI Number Information
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NPI Number | 1205288149
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Entity Type | Individual
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Provider Name | JONATHAN FITZHERBERT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2016
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Last Update Date | 07/03/2016
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Provider Practice Location Address
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Address Line | 315 W MAIN ST
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City | HILLSBORO
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State | NH
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Zip | 03244-5234
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Country | US
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Telephone | 603-464-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 20 DONOVAN CT
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City | MERRIMACK
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State | NH
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Zip | 03054-6214
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Country | US
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Telephone | 401-447-9674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3980
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License Number State | NH
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