Havana Pharmacy and Medical Supply LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

836 Issued in CO

Legal business name

HAVANA PHARMACY AND MEDICAL SUPPLY LLC

Practice address

1555 S Havana St Unit HJ
Aurora, CO 80012-5004

Phone

(303) 750-3600

Fax

(303) 750-3607

NPI assigned

Dec 13, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George Sackey, RPHNPI 1891066338

Title

Pharmacist/Owner

Phone

(303) 668-0032

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Havana Pharmacy and Medical Supply Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Sackey

  • Pharmacist
  • Aurora, CO
  • NPI 1891066338
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1972871333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S HAVANA ST UNIT HJ",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125004",
            "telephone_number": "303-750-3600",
            "fax_number": "303-750-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S HAVANA ST UNIT HJ",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125004",
            "telephone_number": "303-750-3600",
            "fax_number": "303-750-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVANA PHARMACY AND MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "SACKEY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "303-668-0032",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "836",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0622363",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havana Pharmacy and Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Leigh Hauser-Roe, NNP
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• Community/Retail Pharmacy in Aurora, CO
• Providers in Aurora, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.