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General NPI Number Information
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NPI Number | 1356786941
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Entity Type | Organization
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Legal Business Name | TROY PHARMACY
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 11/21/2013
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Provider Practice Location Address
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Address Line | 5901 S TROY ST
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City | CHICAGO
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State | IL
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Zip | 60629-2512
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Country | US
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Telephone | 773-498-4577
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Fax | 773-498-8531
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Provider Business Mailing Address
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Address Line | 5901 S TROY ST
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City | CHICAGO
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State | IL
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Zip | 60629-2512
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Country | US
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Telephone | 773-498-4577
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Fax | 773-498-8531
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAWAD H HAMDAN
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Credential | PHARMD
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Telephone | 773-498-4577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 054018217
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 054018217
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 054018217
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 054018217
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054018217
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License Number State | IL
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