Provider Demographics
NPI:1316217417
Name:HAHN, ERICA G (R PH)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:G
Last Name:HAHN
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 POWHATAN PKWY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2778
Mailing Address - Country:US
Mailing Address - Phone:708-361-0612
Mailing Address - Fax:
Practice Address - Street 1:1309 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2832
Practice Address - Country:US
Practice Address - Phone:757-229-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist