Provider Demographics
NPI:1255455168
Name:HARTMAN, RON COLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RON
Middle Name:COLE
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 MEADOWDALE ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-1264
Mailing Address - Country:US
Mailing Address - Phone:641-684-8044
Mailing Address - Fax:641-684-5407
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2542
Practice Address - Country:US
Practice Address - Phone:641-684-5453
Practice Address - Fax:641-684-5407
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist