# TROY PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MexiCare Pharmacy III
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356786941
- **Authorized official:** DR. JAWAD H HAMDAN PHARMD (OWNER)
- **Authorized official phone:** (773) 498-4577

## Contact information

- **Practice address:** 5901 S TROY ST, CHICAGO, IL 60629-2512
- **Practice address phone:** (773) 498-4577
- **Practice address fax:** (773) 498-8531
- **Mailing address:** 5901 S TROY ST, CHICAGO, IL 60629-2512
- **Mailing address phone:** (773) 498-4577
- **Mailing address fax:** (773) 498-8531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 054018217 | IL | — |
| 332BC3200X | Customized Equipment (DME) | 054018217 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | 054018217 | IL | Yes |
| 3336C0004X | Compounding Pharmacy | 054018217 | IL | — |
| 3336S0011X | Specialty Pharmacy | 054018217 | IL | — |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 11/21/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 455252784001 | — | IL |