Organization
HAWTHORNE PHARMACY LLC
Active
Other names
Hawthorne Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK CARUSO (PIC/MANAGING MEMBER)
(513) 299-7967
Entity
Organization
Contact information
Practice address
3320 TYLERSVILLE RD, HAMILTON, OH 45011-7714
(513) 299-7967
(513) 285-3147
Mailing address
3320 TYLERSVILLE RD, HAMILTON, OH 45011-7714
(513) 299-7967
(513) 285-3147
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP.022648650-0
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166145
PK
—
Enumeration date
11/04/2016
Last updated
02/15/2017
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