Provider Demographics
NPI:1710049291
Name:HARDINS DRUG STORE NO 2 INC
Entity Type:Organization
Organization Name:HARDINS DRUG STORE NO 2 INC
Other - Org Name:HARDIN'S DRUG 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KERA
Authorized Official - Middle Name:F
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-657-5353
Mailing Address - Street 1:1281 US HIGHWAY 221A
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-5921
Mailing Address - Country:US
Mailing Address - Phone:828-657-5353
Mailing Address - Fax:828-657-5729
Practice Address - Street 1:1281 US HIGHWAY 221A
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-5921
Practice Address - Country:US
Practice Address - Phone:828-657-5353
Practice Address - Fax:828-657-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC038113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701231OtherMEDICAID DME
NCNCPDPOther3418654
NC0815233Medicaid
NC0592750001Medicare NSC