Provider Demographics
NPI:1649315755
Name:HANGER DRUG COMPANY INCORP.
Entity type:Organization
Organization Name:HANGER DRUG COMPANY INCORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-280-7135
Mailing Address - Street 1:207 SPARKS AVE. SUITE 3
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-2944
Mailing Address - Country:US
Mailing Address - Phone:812-280-7135
Mailing Address - Fax:812-280-7142
Practice Address - Street 1:207 SPARKS AVE
Practice Address - Street 2:SUITE 003
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3739
Practice Address - Country:US
Practice Address - Phone:812-280-7135
Practice Address - Fax:812-280-7142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100294320AMedicaid
IN100294320AMedicaid