Provider Demographics
NPI:1609108000
Name:HARTWELL RX, INC.
Entity Type:Organization
Organization Name:HARTWELL RX, INC.
Other - Org Name:HARTWELL DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:BOLES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:706-376-5801
Mailing Address - Street 1:118 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-1851
Mailing Address - Country:US
Mailing Address - Phone:706-376-5801
Mailing Address - Fax:706-376-8687
Practice Address - Street 1:118 ATHENS ST
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-1851
Practice Address - Country:US
Practice Address - Phone:706-376-5801
Practice Address - Fax:706-376-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy