Provider Demographics
NPI:1164160271
Name:FOSTERS PHARMACY, INC.
Entity Type:Organization
Organization Name:FOSTERS PHARMACY, INC.
Other - Org Name:FOSTER'S PHARMACY LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-392-0911
Mailing Address - Street 1:207 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-2427
Mailing Address - Country:US
Mailing Address - Phone:740-392-0911
Mailing Address - Fax:740-392-0960
Practice Address - Street 1:207 W HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-2427
Practice Address - Country:US
Practice Address - Phone:740-392-0911
Practice Address - Fax:740-392-0960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOSTER'S PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-27
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0471127Medicaid