Healthcare Provider Details

I. General information

NPI: 1831873561
Provider Name (Legal Business Name): HARMON'S DRUG STORE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N ALLEN ST STE A
ROBINSON IL
62454-1168
US

IV. Provider business mailing address

PO BOX 159
OBLONG IL
62449-0159
US

V. Phone/Fax

Practice location:
  • Phone: 618-546-7001
  • Fax: 833-702-3551
Mailing address:
  • Phone: 618-592-4231
  • Fax: 618-592-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRAD E HARMON
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 618-592-4231