Provider Demographics
NPI:1508315268
Name:HANOVER PHARMACY, LLC.
Entity Type:Organization
Organization Name:HANOVER PHARMACY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:708-831-5910
Mailing Address - Street 1:6201 W TOUHY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-1100
Mailing Address - Country:US
Mailing Address - Phone:708-831-5910
Mailing Address - Fax:708-831-5912
Practice Address - Street 1:1802 IRVING PARK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3254
Practice Address - Country:US
Practice Address - Phone:708-831-5910
Practice Address - Fax:708-831-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy