Brian William Hansen, R.PH.
Individual provider Active NPI Pharmacist · Algoma, WI
NPI 1235797911 · NPPES record last updated May 29, 2019
Key facts
- NPI
- 1235797911
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- R7690 (WI)
- Practice address
- N6719 Highway 42
Algoma, WI 54201-9703 - Phone
- (920) 559-2373
- NPI assigned
- May 29, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7690 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | R7690 | WI | Yes |
Addresses
Primary practice location
N6719 Highway 42
Algoma, WI 54201-9703
Mailing address
N6719 Highway 42
Algoma, WI 54201-9703
Phone (920) 559-2373
Other providers in Algoma, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.