Organization
HEARTLAND PHARMACY 2 LLC
Active
Other names
Heartland Pharmacy 2 LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KINDY GHUSSIN RPH (OWNER)
(937) 829-1012
Entity
Organization
Contact information
Practice address
2749 W ALEX BELL RD, MORAINE, OH 45459-1123
(937) 395-3690
(937) 395-3694
Mailing address
2749 W ALEX BELL RD, MORAINE, OH 45459-1123
(937) 395-3690
(937) 395-3694
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022243550
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073255
—
OH
01
—
2137123
PK
—
Enumeration date
09/11/2012
Last updated
02/25/2015
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