Provider Demographics
NPI:1588052492
Name:HASTINGS PHARMACY
Entity type:Organization
Organization Name:HASTINGS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBLET
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:269-420-2990
Mailing Address - Street 1:400 W STATE ST
Mailing Address - Street 2:P.O. BOX 722
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1640
Mailing Address - Country:US
Mailing Address - Phone:269-945-3777
Mailing Address - Fax:269-945-3065
Practice Address - Street 1:400 W STATE ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1640
Practice Address - Country:US
Practice Address - Phone:269-945-3777
Practice Address - Fax:269-945-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010106163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy