Provider Demographics
NPI:1073583027
Name:HAMMER PHARMACY COMPANY
Entity Type:Organization
Organization Name:HAMMER PHARMACY COMPANY
Other - Org Name:HAMMER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-243-4179
Mailing Address - Street 1:600 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1924
Mailing Address - Country:US
Mailing Address - Phone:515-243-4177
Mailing Address - Fax:515-243-3517
Practice Address - Street 1:600 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1924
Practice Address - Country:US
Practice Address - Phone:515-243-4177
Practice Address - Fax:515-243-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0037242Medicaid
IA1229140001Medicare ID - Type Unspecified