Provider Demographics
NPI:1083611867
Name:HART PHARMACY INC
Entity Type:Organization
Organization Name:HART PHARMACY INC
Other - Org Name:HART PHARMACY & HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-683-5621
Mailing Address - Street 1:6217 E 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-2654
Mailing Address - Country:US
Mailing Address - Phone:316-683-5621
Mailing Address - Fax:
Practice Address - Street 1:6217 E 13TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2654
Practice Address - Country:US
Practice Address - Phone:316-683-5621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
KS2131713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100455860BMedicaid
2027082OtherPK
KS100455860EMedicaid
KS100455860AMedicaid
KS100455860CMedicaid
KS100455860DMedicaid
2027082OtherPK
KS118351OtherEL DORADO
KS100455860CMedicaid
KS100455860EMedicaid