# HEARTLAND PHARMACY 2 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heartland Pharmacy 2 LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083964787
- **Authorized official:** KINDY GHUSSIN RPH (OWNER)
- **Authorized official phone:** (937) 829-1012

## Contact information

- **Practice address:** 2749 W ALEX BELL RD, MORAINE, OH 45459-1123
- **Practice address phone:** (937) 395-3690
- **Practice address fax:** (937) 395-3694
- **Mailing address:** 2749 W ALEX BELL RD, MORAINE, OH 45459-1123
- **Mailing address phone:** (937) 395-3690
- **Mailing address fax:** (937) 395-3694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 022243550 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/11/2012
- **Last updated:** 02/25/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0073255 | — | OH |
| 01 | — | 2137123 | PK | — |