Provider Demographics
NPI:1972598738
Name:HANNA PHARMACY LLC
Entity Type:Organization
Organization Name:HANNA PHARMACY LLC
Other - Org Name:NORTH PORT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TULSIBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-426-1123
Mailing Address - Street 1:13221 TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287
Mailing Address - Country:US
Mailing Address - Phone:941-426-1123
Mailing Address - Fax:941-423-2827
Practice Address - Street 1:13221 TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287
Practice Address - Country:US
Practice Address - Phone:941-426-1123
Practice Address - Fax:941-423-2827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X, 333600000X, 3336C0003X
FLPH66253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129444OtherPK