Organization
AMICARE PHARMACY, INC
Active
Other names
HART MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MERIDETH RPH (MANAGER)
(309) 517-6710
Entity
Organization
Contact information
Practice address
4101 JOHN DEERE RD, MOLINE, IL 61265-6790
(309) 517-6710
(309) 517-6708
Mailing address
4101 JOHN DEERE RD, MOLINE, IL 61265-6790
(309) 517-6710
(309) 517-6708
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203001033
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113120
—
IA
01
—
2021706
PK
—
05
—
363807756001
—
IL
Enumeration date
11/27/2006
Last updated
07/10/2015
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