Provider Demographics
NPI:1871628248
Name:HASCO INCORPORATED
Entity type:Organization
Organization Name:HASCO INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARVIS
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:HOUCK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:641-357-2634
Mailing Address - Street 1:8 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-1815
Mailing Address - Country:US
Mailing Address - Phone:641-357-2634
Mailing Address - Fax:
Practice Address - Street 1:8 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-1815
Practice Address - Country:US
Practice Address - Phone:641-357-2634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA12338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty