Provider Demographics
NPI:1124831573
Name:HANSA PHARMACY LLC
Entity type:Organization
Organization Name:HANSA PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:CHIRANJIVI
Authorized Official - Middle Name:BHARATH
Authorized Official - Last Name:JANNU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-617-6784
Mailing Address - Street 1:1111 SE FEDERAL HWY STE 122
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3802
Mailing Address - Country:US
Mailing Address - Phone:772-617-6784
Mailing Address - Fax:772-617-6782
Practice Address - Street 1:1111 SE FEDERAL HWY STE 122
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3802
Practice Address - Country:US
Practice Address - Phone:772-617-6784
Practice Address - Fax:772-617-6782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy