NPI 1083105837

Mario Hanna

Practitioner Pharmacist Brunswick, GA

Practice location

Address: 4575 Altama Ave, Brunswick, GA 31520-3008
Phone: (925) 917-1507

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 030461 (GA)

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Registry record

NPI: 1083105837
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 May 2018
Record last updated: 22 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.