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General NPI Number Information
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NPI Number | 1477085876
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Entity Type | Individual
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Provider Name | DAVID HERNANDEZ ANGELES RPH
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Gender | Male
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1414 3RD ST NW
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City | GREAT FALLS
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State | MT
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Zip | 59404-1928
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Country | US
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Telephone | 406-761-8420
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Fax | 406-727-0336
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Provider Business Mailing Address
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Address Line | 3205 13TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5460
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Country | US
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Telephone | 406-453-5060
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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 | 39711
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License Number State | MT
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