MEDICARE: ERICA G. HAHN R PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202210233	VA

General Provider Information

NPI Number	:	1316217417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA G. HAHN R PH

Provider Business Mailing Address
First Line	:	3920 POWHATAN PKWY
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-2778
Country	:	US
Telephone Number	:	708-361-0612
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 RICHMOND RD
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-2832
Country	:	US
Telephone Number	:	757-229-0754
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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