MEDICARE: BRETT HANSEN 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
1	183500000X	Pharmacist	20835	IA

General Provider Information

NPI Number	:	1740569276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT HANSEN PHARMD

Provider Business Mailing Address
First Line	:	340 S STATE ST
Second Line	:	PO BOX 120
City	:	DENVER
State	:	IA
Zip	:	50622
Country	:	US
Telephone Number	:	319-984-5691
Fax Number	:	319-984-5687

Provider Business Practice Location Address
First Line	:	340 S STATE ST
Second Line	:
City	:	DENVER
State	:	IA
Zip	:	50622-7706
Country	:	US
Telephone Number	:	319-984-5691
Fax Number	:	319-984-5687

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

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	10/02/2019

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Directions to “ BRETT HANSEN PHARMD” Practice Location

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