Provider Demographics
NPI:1275245060
Name:CHESTERFIELD PHARMACY LLC
Entity Type:Organization
Organization Name:CHESTERFIELD PHARMACY LLC
Other - Org Name:CHESTERFIELD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-805-5301
Mailing Address - Street 1:37532 JEFFERSON AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34845 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-3647
Practice Address - Country:US
Practice Address - Phone:586-210-5246
Practice Address - Fax:586-684-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy