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Contact Information

HEARTLAND PHARMACY LLC
3000 FAR HILLS AVE
KETTERING, OH45429-2510
 Phone: 937-723-9075
 Fax: 937-723-9450
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for HEARTLAND PHARMACY LLC

NPI Number 1811247505
LBN Legal business name HEARTLAND PHARMACY LLC
Authorized official KINDY GHUSSIN - (OWNER, PIC)
Entity Organization
Organization subpart 1 No
Enumeration date 09/11/2012
Last updated 09/19/2025 - About 9 months ago
Identifiers
OH License # 022241550
OH Medicaid 0073227
Other 2137122 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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