Heartland Pharmacy 2 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022243550 Issued in OH

Legal business name

HEARTLAND PHARMACY 2 LLC

Doing business as

Heartland Pharmacy 2 LLC

Practice address

2749 W Alex Bell Rd
Moraine, OH 45459-1123

Phone

(937) 395-3690

Fax

(937) 395-3694

NPI assigned

Sep 11, 2012

Last updated

Feb 25, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kindy Ghussin, RPH

Title

Owner

Phone

(937) 829-1012

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Heartland Pharmacy 2 LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1083964787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 W ALEX BELL RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454591123",
            "telephone_number": "937-395-3690",
            "fax_number": "937-395-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 W ALEX BELL RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454591123",
            "telephone_number": "937-395-3690",
            "fax_number": "937-395-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND PHARMACY 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "GHUSSIN",
        "authorized_official_first_name": "KINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-829-1012",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022243550",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073255",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137123",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Pharmacy 2 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Moraine, OH
• Providers in Moraine, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.