Provider Demographics
NPI:1235140732
Name:HEERA CORPORATION
Entity Type:Organization
Organization Name:HEERA CORPORATION
Other - Org Name:DEV PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST PIC
Authorized Official - Prefix:
Authorized Official - First Name:MAHENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:630-851-3870
Mailing Address - Street 1:364 N FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3083
Mailing Address - Country:US
Mailing Address - Phone:630-851-3870
Mailing Address - Fax:630-851-0887
Practice Address - Street 1:364 N FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3083
Practice Address - Country:US
Practice Address - Phone:630-851-3870
Practice Address - Fax:630-851-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
IL0540083563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2018206OtherPK
2018206OtherPK
2018206OtherPK