Provider Demographics
NPI:1871878009
Name:HAMMER, EVAN J (RPH)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:J
Last Name:HAMMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-5738
Mailing Address - Country:US
Mailing Address - Phone:319-753-1639
Mailing Address - Fax:319-753-0452
Practice Address - Street 1:201 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-5738
Practice Address - Country:US
Practice Address - Phone:319-753-1639
Practice Address - Fax:319-753-0452
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist