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NPI Code Detail

MEDICARE: MR. BRYAN JAY HAHNER RPH

MEDICARE: MR. BRYAN JAY HAHNER RPH
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
1183500000XPharmacistPH00013648WA

General Provider Information

NPI Number : 1720202047
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN JAY HAHNER RPH
Provider Business Mailing Address
First Line : 241 FAIRBANKS NORTH RD
Second Line :
City : ROSALIA
State : WA
Zip : 99170-9530
Country : US
Telephone Number : 509-242-9665
Fax Number :
Provider Business Practice Location Address
First Line : 5601 E SPRAGUE AVE
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99212-0826
Country : US
Telephone Number : 509-842-0002
Fax Number : 509-842-0009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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