Provider Demographics
NPI:1982694063
Name:HOINES PHARMACIES INC
Entity Type:Organization
Organization Name:HOINES PHARMACIES INC
Other - Org Name:HOINES HEALTHMART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:563-547-3401
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1519
Mailing Address - Country:US
Mailing Address - Phone:563-547-3401
Mailing Address - Fax:563-547-3305
Practice Address - Street 1:113 N ELM ST
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1519
Practice Address - Country:US
Practice Address - Phone:563-547-3401
Practice Address - Fax:563-547-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2025883OtherPK
IA0076893Medicaid
0147560001Medicare NSC