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Organization
TROY PHARMACY
Active
Organization
TROY PHARMACY
Active
Other names
MexiCare Pharmacy III
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAWAD H HAMDAN PHARMD (OWNER)
(773) 498-4577
Entity
Organization
Contact information
Practice address
5901 S TROY ST, CHICAGO, IL 60629-2512
(773) 498-4577
(773) 498-8531
Mailing address
5901 S TROY ST, CHICAGO, IL 60629-2512
(773) 498-4577
(773) 498-8531
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054018217
IL
332BC3200X
Customized Equipment (DME)
054018217
IL
3336C0003X
Community/Retail Pharmacy
Primary
054018217
IL
3336C0004X
Compounding Pharmacy
054018217
IL
3336S0011X
Specialty Pharmacy
054018217
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455252784001
—
IL
Enumeration date
05/08/2013
Last updated
11/21/2013
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