Provider Demographics
NPI:1184222622
Name:GREENHAW PHARMACY, INC
Entity Type:Organization
Organization Name:GREENHAW PHARMACY, INC
Other - Org Name:HILLSBORO HOMETOWN PHARMACY - LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-947-3784
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-0188
Mailing Address - Country:US
Mailing Address - Phone:620-654-7330
Mailing Address - Fax:620-947-2801
Practice Address - Street 1:507 N ASH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1102
Practice Address - Country:US
Practice Address - Phone:620-947-3784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy