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Organization

QUINCY DRUG CO INC

Active
Other names
HEARTLAND PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DAVE MANNING (PRES)
(509) 781-4431
Entity
Organization

Contact information

Practice address
101 F ST SW, QUINCY, WA 98848-1213
(509) 787-4437
(509) 781-5012
Mailing address
101 F ST SW, QUINCY, WA 98848-1213
(509) 787-4437
(509) 781-5012

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.00002339
WA
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4916067
NCPDP PROVIDER IDENTIFICATION NUMBER
05
6147003
WA
Enumeration date
07/30/2006
Last updated
09/14/2012
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