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General NPI Number Information
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NPI Number | 1457644411
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Entity Type | Individual
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Provider Name | HANS WERNER BOTTESCH R.PH.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 126 WHITE BIRCH LN
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City | DALLAS
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State | PA
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Zip | 18612-9147
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Country | US
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Telephone | 570-594-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 SUNNY LN
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City | DANVILLE
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State | PA
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Zip | 17821-8787
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Country | US
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Telephone | 570-594-0705
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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 | RP030438L
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License Number State | PA
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