Provider Demographics
NPI:1013083773
Name:HONEYMAN DRUG STONER DRUG CO INC
Entity Type:Organization
Organization Name:HONEYMAN DRUG STONER DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:712-826-4112
Mailing Address - Street 1:408 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:VILLISCA
Mailing Address - State:IA
Mailing Address - Zip Code:50864-1213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:408 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:VILLISCA
Practice Address - State:IA
Practice Address - Zip Code:50864-1213
Practice Address - Country:US
Practice Address - Phone:712-826-4112
Practice Address - Fax:712-826-4112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STONER DRUG CO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-27
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA61332B00000X
333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0198721Medicaid
1607487OtherOTHER ID NUMBER-COMMERCIAL NUMBER