Healthcare Provider Details

I. General information

NPI: 1245389949
Provider Name (Legal Business Name): HARDING ROAD PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W HARDING RD
SPRINGFIELD OH
45504-1707
US

IV. Provider business mailing address

400 W HARDING RD
SPRINGFIELD OH
45504-1707
US

V. Phone/Fax

Practice location:
  • Phone: 937-399-8531
  • Fax: 937-399-4911
Mailing address:
  • Phone: 937-399-8531
  • Fax: 937-399-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number069470001
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number020181950
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02-0181950
License Number StateOH

VIII. Authorized Official

Name: MR. DWIGHT ALLEN DOBBINS
Title or Position: OWNER
Credential: R.PH.
Phone: 937-399-8531