Basic Information
| Provider Information | |||||||||
| NPI: | 1174784334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORIDA HHI LLC | ||||||||
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| OtherOrganizationName: | FLORIDA HHI LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 MCCLINTOCK DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BURR RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605270871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882206432 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6704 BENJAMIN RD | ||||||||
| Address2: | STE 700 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336344408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139837970 | ||||||||
| FaxNumber: | 8139839777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2008 | ||||||||
| LastUpdateDate: | 12/13/2013 | ||||||||
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| AuthorizedOfficialLastName: | STANTON | ||||||||
| AuthorizedOfficialFirstName: | NEIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 6306556720 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336H0001X | PH23430 | FL | Y | Suppliers | Pharmacy | Home Infusion Therapy Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 1039002 | 01 | NCPDP PROVIDER IDENTIFICATION NUMBER | OTHER |