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General NPI Number Information
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NPI Number | 1063554178
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Entity Type | Organization
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Legal Business Name | HANOVER HEALTHCARE LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 434 RIDGEDALE AVE
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City | EAST HANOVER
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State | NJ
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Zip | 07936-1403
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Country | US
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Telephone | 973-781-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 434 RIDGEDALE AVE
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City | EAST HANOVER
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State | NJ
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Zip | 07936-1403
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Country | US
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Telephone | 973-781-9877
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Fax | 973-781-9866
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL AUSLANDER
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Credential | R PH.
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Telephone | 973-781-9877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5670
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5670
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License Number State | NJ
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