Provider Demographics
NPI:1679613459
Name:HASSELBRING, BRITT N (RPH)
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:N
Last Name:HASSELBRING
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 1:728 S MAIN ST
Mailing Address - Street 2:P.O. BOX 630
Mailing Address - City:CONCORDIA
Mailing Address - State:MO
Mailing Address - Zip Code:64020-9602
Mailing Address - Country:US
Mailing Address - Phone:660-463-2519
Mailing Address - Fax:660-463-7732
Practice Address - Street 1:728 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:MO
Practice Address - Zip Code:64020-9602
Practice Address - Country:US
Practice Address - Phone:660-463-2519
Practice Address - Fax:660-463-7732
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2620462OtherNCPDP #
MO004176OtherSTATE LICENSE
MO2620462OtherNCPDP #