Provider Demographics
NPI:1427619030
Name:BLUME, HANNAH MOORE
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:MOORE
Last Name:BLUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 HIDDEN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-2512
Mailing Address - Country:US
Mailing Address - Phone:864-490-7406
Mailing Address - Fax:
Practice Address - Street 1:200 N HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-2300
Practice Address - Country:US
Practice Address - Phone:864-834-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist