MEDICARE: WERNER DRUG CO. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	100150400A	IN
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	100150400A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1500532	OTHER	IN	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780632059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WERNER DRUG CO. INC.

Provider Business Mailing Address
First Line	:	1134 WASHINGTON ST
Second Line	:
City	:	TELL CITY
State	:	IN
Zip	:	47586-1827
Country	:	US
Telephone Number	:	812-547-5586
Fax Number	:	812-547-4368

Provider Business Practice Location Address
First Line	:	1134 WASHINGTON ST
Second Line	:
City	:	TELL CITY
State	:	IN
Zip	:	47586-1827
Country	:	US
Telephone Number	:	812-547-5586
Fax Number	:	812-547-4368

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRAD N HARTH
Credential	:	R.PH.
Telephone Number	:	812-547-5586

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	01/07/2010

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