Organization
HARDINGS GALESBURG MARKET INC
Active
Other names
Harding's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN GUSTAVSON (DIRECTOR OF PHARMACY)
(269) 492-2919
Entity
Organization
Contact information
Practice address
3750 W CENTRE AVE, PORTAGE, MI 49024-4630
(269) 323-7380
(269) 323-7392
Mailing address
3750 W CENTRE AVE, PORTAGE, MI 49024-4630
(269) 323-7380
(269) 323-7392
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301006958
MI
333600000X
Pharmacy
5301006958
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301006958
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2359695
NCPDP
—
05
—
50-2359695
—
MI
05
—
87-4835868
—
MI
Enumeration date
08/22/2006
Last updated
06/12/2008
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