Provider Demographics
NPI:1962833202
Name:HAPPY HORMONE COTTAGE LLC
Entity Type:Organization
Organization Name:HAPPY HORMONE COTTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMASIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOGRETE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-600-9879
Mailing Address - Street 1:649 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2149
Mailing Address - Country:US
Mailing Address - Phone:513-600-9879
Mailing Address - Fax:
Practice Address - Street 1:649 W HIGH ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2149
Practice Address - Country:US
Practice Address - Phone:513-600-9879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty