Provider Demographics
NPI:1639482961
Name:HTTS LLC
Entity type:Organization
Organization Name:HTTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINNAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-270-1500
Mailing Address - Street 1:PO BOX 87918
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-0918
Mailing Address - Country:US
Mailing Address - Phone:313-270-1500
Mailing Address - Fax:888-294-9677
Practice Address - Street 1:18400 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1126
Practice Address - Country:US
Practice Address - Phone:313-270-1500
Practice Address - Fax:888-294-9677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
MI53010093633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2374255OtherNCPDP PROVIDER IDENTIFICATION NUMBER