Harry Graydon Bauman

Individual provider Active NPI Pharmacist · Mill Hall, PA

NPI 1366812554 · NPPES record last updated Sep 30, 2015

Key facts

NPI
1366812554
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
RP446874 (PA)
Practice address
260 Main St
Mill Hall, PA 17751-1707
Phone
(570) 726-3213
Fax
(570) 726-3020
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RP446874PAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP446874 PA Yes

Addresses

Primary practice location

260 Main St
Mill Hall, PA 17751-1707

Mailing address

260 Main St
Mill Hall, PA 17751-1707
Phone (570) 726-3213

Other providers in Mill Hall, PA

All providers in Mill Hall, PA · Pharmacist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.