Provider Demographics
NPI:1629210943
Name:HT THREE LLC
Entity Type:Organization
Organization Name:HT THREE LLC
Other - Org Name:J&L PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-950-9120
Mailing Address - Street 1:8300 E MAPLEWOOD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4804
Mailing Address - Country:US
Mailing Address - Phone:800-950-9120
Mailing Address - Fax:303-221-7775
Practice Address - Street 1:4606 46TH AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-7143
Practice Address - Country:US
Practice Address - Phone:309-786-2124
Practice Address - Fax:888-269-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-166413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy