Provider Demographics
NPI:1750351367
Name:HARDING & HILL INC
Entity type:Organization
Organization Name:HARDING & HILL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSTAVSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-492-2919
Mailing Address - Street 1:5165 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1003
Mailing Address - Country:US
Mailing Address - Phone:269-381-0270
Mailing Address - Fax:269-381-9415
Practice Address - Street 1:5165 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1003
Practice Address - Country:US
Practice Address - Phone:269-381-0270
Practice Address - Fax:269-381-9415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
MI53010063973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2042970OtherPK
MI1750351367Medicaid
MI50-2355596Medicaid
MI87-4835886Medicaid
MI1750351367Medicaid