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NPI Code Detail

MEDICARE: JOHN HANM PHARMD

MEDICARE: JOHN HANM PHARMD
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
1183500000XPharmacist122454MN

General Provider Information

NPI Number : 1366828337
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN HANM PHARMD
Provider Business Mailing Address
First Line : 16600 92ND AVE N
Second Line : 320
City : MAPLE GROVE
State : MN
Zip : 55311-5445
Country : US
Telephone Number : 651-366-7745
Fax Number :
Provider Business Practice Location Address
First Line : 8000 LAKELAND AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55445-2403
Country : US
Telephone Number : 763-424-7077
Fax Number : 763-424-8723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2015
Last Update Date : 07/31/2015

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