Provider Demographics
NPI:1588123608
Name:DANVILLE HC, INC
Entity type:Organization
Organization Name:DANVILLE HC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:R.PH/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-501-3831
Mailing Address - Street 1:PO BOX B
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43014-0602
Mailing Address - Country:US
Mailing Address - Phone:740-481-2300
Mailing Address - Fax:740-481-3019
Practice Address - Street 1:14 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43014
Practice Address - Country:US
Practice Address - Phone:740-481-2300
Practice Address - Fax:740-481-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No3336C0002XSuppliersPharmacyClinic Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363948Medicaid
OH0232000114OtherOHIO STATE BOARD OF PHARMACY LICENSE