Provider Demographics
NPI:1962158915
Name:GREENHILL SPECIALTY PHARMACY LLC.
Entity type:Organization
Organization Name:GREENHILL SPECIALTY PHARMACY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:CHINU
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-660-8847
Mailing Address - Street 1:2500 W 4TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3352
Mailing Address - Country:US
Mailing Address - Phone:302-499-8727
Mailing Address - Fax:302-499-8729
Practice Address - Street 1:2500 W 4TH ST STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3352
Practice Address - Country:US
Practice Address - Phone:302-499-8727
Practice Address - Fax:302-499-8729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0727164Medicaid
MD275012100Medicaid
DE250541490Medicaid
NC00602646Medicaid
OH0457243Medicaid
PA1037088450001Medicaid