MEDICARE: CATHY HAMANN

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	11990-040	WI

General Provider Information

NPI Number	:	1891803524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY HAMANN

Provider Business Mailing Address
First Line	:	2106 GRAND AVE
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54403-6912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2106 GRAND AVE
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54403-6912
Country	:	US
Telephone Number	:	715-845-3713
Fax Number	:	715-845-7957

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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Directions to “ CATHY HAMANN ” Practice Location

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