MEDICARE: MRS. TINA L HAUSNER 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	RP042033L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780678656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TINA L HAUSNER PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 812
Second Line	:	105 FOURTH STREET
City	:	EAST BERLIN
State	:	PA
Zip	:	17316-0812
Country	:	US
Telephone Number	:	717-259-6440
Fax Number	:	717-259-6644

Provider Business Practice Location Address
First Line	:	105 4TH ST
Second Line	:
City	:	EAST BERLIN
State	:	PA
Zip	:	17316-9638
Country	:	US
Telephone Number	:	717-259-6440
Fax Number	:	717-259-6644

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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