Healthcare Provider Details

I. General information

NPI: 1295749133
Provider Name (Legal Business Name): HARMON FOOD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E YOUNG AVE
WARRENSBURG MO
64093-1239
US

IV. Provider business mailing address

410 E YOUNG AVE
WARRENSBURG MO
64093-1239
US

V. Phone/Fax

Practice location:
  • Phone: 660-429-6650
  • Fax: 660-429-6365
Mailing address:
  • Phone: 660-429-6650
  • Fax: 660-429-6365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number006602
License Number StateMO

VIII. Authorized Official

Name: CHARLES E HENSLEY
Title or Position: PHARMACIST
Credential: RPH
Phone: 660-429-6650