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General NPI Number Information
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NPI Number | 1922090158
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Entity Type | Organization
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Legal Business Name | RED CROSS PHARMACY, INC
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 103 E MECHANIC ST
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2461
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Country | US
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Telephone | 816-380-3321
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Fax | 816-887-5206
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Provider Business Mailing Address
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Address Line | PO BOX 917
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City | MARSHALL
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State | MO
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Zip | 65340-0917
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Country | US
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Telephone | 660-886-5535
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Fax | 660-886-6320
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Authorized Official
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Title or Position | CO-PRESIDENT/CEO
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Name | SCOTT B HARTWIG
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Credential |
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Telephone | 660-886-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2008025199
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 004160
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License Number State | MO
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