Provider Demographics
NPI:1528781010
Name:COMMUNITY PHARMACY AT HILLS AND DALES
Entity type:Organization
Organization Name:COMMUNITY PHARMACY AT HILLS AND DALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-322-6270
Mailing Address - Street 1:6190 HOSPITAL DR STE 10
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-1072
Mailing Address - Country:US
Mailing Address - Phone:989-912-6286
Mailing Address - Fax:989-872-2147
Practice Address - Street 1:6190 HOSPITAL DR STE 10
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-1072
Practice Address - Country:US
Practice Address - Phone:989-912-6286
Practice Address - Fax:989-872-2147
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLS & DALES GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy