Provider Demographics
NPI:1558513580
Name:DIEKMANN & HARE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:DIEKMANN & HARE ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:HARE
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-854-4949
Mailing Address - Street 1:963 CHERRY ST E
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-9609
Mailing Address - Country:US
Mailing Address - Phone:330-854-4949
Mailing Address - Fax:330-854-1919
Practice Address - Street 1:963 CHERRY ST E
Practice Address - Street 2:
Practice Address - City:CANAL FULTON
Practice Address - State:OH
Practice Address - Zip Code:44614-9609
Practice Address - Country:US
Practice Address - Phone:330-854-4949
Practice Address - Fax:330-854-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020145800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0135240001Medicare NSC