Provider Demographics
NPI:1891561882
Name:HANINI RX LLC
Entity Type:Organization
Organization Name:HANINI RX LLC
Other - Org Name:BROADWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:440-532-3538
Mailing Address - Street 1:802 TOLLIS PKWY
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1805
Mailing Address - Country:US
Mailing Address - Phone:216-331-3642
Mailing Address - Fax:216-465-1635
Practice Address - Street 1:3782 W 117TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5265
Practice Address - Country:US
Practice Address - Phone:216-331-3642
Practice Address - Fax:216-465-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy