Provider Demographics
NPI:1538578422
Name:HANSFORD, JO BETH (PHARMD)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:BETH
Last Name:HANSFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JO
Other - Middle Name:BETH
Other - Last Name:HANSFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3551 US HWY 441 S
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974
Mailing Address - Country:US
Mailing Address - Phone:863-763-0428
Mailing Address - Fax:863-215-7921
Practice Address - Street 1:3551 US HWY 441 S
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974
Practice Address - Country:US
Practice Address - Phone:863-763-0428
Practice Address - Fax:863-215-7921
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist