Provider Demographics
NPI:1861708398
Name:ABRAHAM, HANLEY K (RPH)
Entity type:Individual
Prefix:MR
First Name:HANLEY
Middle Name:K
Last Name:ABRAHAM
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 1:1642 DICKERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2764
Mailing Address - Country:US
Mailing Address - Phone:704-289-8583
Mailing Address - Fax:704-283-5321
Practice Address - Street 1:1642 DICKERSON BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2764
Practice Address - Country:US
Practice Address - Phone:704-289-8583
Practice Address - Fax:704-283-5321
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist