Healthcare Provider Details

I. General information

NPI: 1982694063
Provider Name (Legal Business Name): HOINES PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N ELM ST
CRESCO IA
52136-1519
US

IV. Provider business mailing address

113 N ELM ST
CRESCO IA
52136-1519
US

V. Phone/Fax

Practice location:
  • Phone: 563-547-3401
  • Fax: 563-547-3305
Mailing address:
  • Phone: 563-547-3401
  • Fax: 563-547-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number207
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2025883
Identifier TypeOTHER
Identifier State
Identifier IssuerPK
# 2
Identifier0076893
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: JAROLD HUGHES
Title or Position: PRESIDENT
Credential: RPH
Phone: 563-547-3401