Provider Demographics
NPI:1043836042
Name:HANAN PHARMACY LLC
Entity Type:Organization
Organization Name:HANAN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHARMACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-999-5951
Mailing Address - Street 1:4600 E 14 MILE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-4369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4600 E 14 MILE ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-1057
Practice Address - Country:US
Practice Address - Phone:586-999-5951
Practice Address - Fax:586-554-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy