Healthcare Provider Details

I. General information

NPI: 1316958358
Provider Name (Legal Business Name): HEARTLAND PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 US HIGHWAY 27 N E-7
SEBRING FL
33870-7840
US

IV. Provider business mailing address

PO BOX 5047
MERIDIAN MS
39302-5047
US

V. Phone/Fax

Practice location:
  • Phone: 863-385-2866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPH10353
License Number StateFL

VIII. Authorized Official

Name: R DUNCAN
Title or Position: OWNER
Credential:
Phone: 863-385-2866