Provider Demographics
NPI:1114102167
Name:H&N DRUG
Entity Type:Organization
Organization Name:H&N DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-598-3674
Mailing Address - Street 1:515 MEMORIAL DR.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962
Mailing Address - Country:US
Mailing Address - Phone:606-598-3674
Mailing Address - Fax:606-598-0007
Practice Address - Street 1:515 MEMORIAL DR.
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962
Practice Address - Country:US
Practice Address - Phone:606-598-3674
Practice Address - Fax:606-598-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY90010265332B00000X
KYP01026332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54013784Medicaid
KY90010265Medicaid