Provider Demographics
NPI:1861254401
Name:DANVILLE HC, INC
Entity type:Organization
Organization Name:DANVILLE HC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
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:740-481-2300
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 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43014-9807
Practice Address - Country:US
Practice Address - Phone:740-481-2300
Practice Address - Fax:740-481-3019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANVILLE HC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363948Medicaid