MEDICARE: MARK HANUS 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
1	183500000X	Pharmacist	26732	TX

General Provider Information

NPI Number	:	1881047421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK HANUS RPH.

Provider Business Mailing Address
First Line	:	1862 W BITTERS RD
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-1809
Country	:	US
Telephone Number	:	210-718-0300
Fax Number	:	210-255-1461

Provider Business Practice Location Address
First Line	:	1862 W BITTERS RD
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-1809
Country	:	US
Telephone Number	:	210-718-0300
Fax Number	:	210-255-1461

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

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	07/19/2016

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