Provider Demographics
NPI:1871913640
Name:HOOVER DRUGS LLC
Entity type:Organization
Organization Name:HOOVER DRUGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:SATYA-MURHTY
Authorized Official - Last Name:GERA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:586-522-4334
Mailing Address - Street 1:28675 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4105
Mailing Address - Country:US
Mailing Address - Phone:586-522-4334
Mailing Address - Fax:586-920-2678
Practice Address - Street 1:28675 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4152
Practice Address - Country:US
Practice Address - Phone:586-522-4334
Practice Address - Fax:586-920-2678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010104123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy