Provider Demographics
NPI:1144028226
Name:THE HRT CLUB PHARMACY, LLC
Entity type:Organization
Organization Name:THE HRT CLUB PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MUNIGHAN
Authorized Official - Last Name:DARISSE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:978-908-9552
Mailing Address - Street 1:100 SOMERSET CORPORATE BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2842
Mailing Address - Country:US
Mailing Address - Phone:978-908-9552
Mailing Address - Fax:
Practice Address - Street 1:5151 MONROE ST STE 244C
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3461
Practice Address - Country:US
Practice Address - Phone:978-908-9552
Practice Address - Fax:844-832-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy