Healthcare Provider Details

I. General information

NPI: 1447203484
Provider Name (Legal Business Name): HASE PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S MAIN ST
ANNA IL
62906-1241
US

IV. Provider business mailing address

313 S MAIN ST
ANNA IL
62906-1241
US

V. Phone/Fax

Practice location:
  • Phone: 618-833-8545
  • Fax: 618-833-8547
Mailing address:
  • Phone: 618-833-8545
  • Fax: 618-833-8547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. DAVID KEITH SMILEY
Title or Position: PRESIDENT
Credential: RPH
Phone: 618-833-8545