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NPI Code Detail

MEDICARE: DARRELL HANSCHEN

MEDICARE:   DARRELL  HANSCHEN
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
1183500000XPharmacist40555MO

General Provider Information

NPI Number : 1669841979
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRELL HANSCHEN
Provider Business Mailing Address
First Line : 2220 MAIN ST
Second Line :
City : SCOTT CITY
State : MO
Zip : 63780-1329
Country : US
Telephone Number : 573-264-2450
Fax Number :
Provider Business Practice Location Address
First Line : 2220 MAIN ST
Second Line :
City : SCOTT CITY
State : MO
Zip : 63780-1329
Country : US
Telephone Number : 573-264-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2015
Last Update Date : 09/16/2015

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Directions to “ DARRELL HANSCHEN ” Practice Location

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