Provider Demographics
NPI:1316232853
Name:HVIID, PATRINA ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRINA
Middle Name:ANN
Last Name:HVIID
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 URBANA PIKE
Mailing Address - Street 2:T1137
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7275
Mailing Address - Country:US
Mailing Address - Phone:301-624-2045
Mailing Address - Fax:301-624-2045
Practice Address - Street 1:5437 URBANA PIKE
Practice Address - Street 2:T1137
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7275
Practice Address - Country:US
Practice Address - Phone:301-624-2045
Practice Address - Fax:301-624-2045
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist